Acute kidney injury and its prognostic value for patients with metabolic syndrome and intact glomerular filtration who underwent coronary artery bypass grafting


B.G. Iskenderov, O.N. Sisina

SBEI FPE "Penza Institute of Advanced Training" of RMPH
Purpose. To determine the incidence of acute kidney injury (AKI) and its prognostic value for patients with metabolic syndrome (MS) and intact glomerular filtration undergoing coronary artery bypass grafting (CABG).
Material and methods. A total of 782 patients (514 men and 268 women) aged 54 to 67 years (mean age – 62.3 ± 4.6 years), who routinely underwent CABG with extracorporeal circulation, were evaluated. Of these, 513 (65.6%) patients had no diagnostic criteria for MS (Group 1), while 269 (34.4%) patients were diagnosed with MS (Group 2). For all patients, the initial value of the glomerular filtration rate (GFR) was greater than 60 mL/min/1.73 m2, as defined by EPI-CKD creatinine equation.
Results. In Group 1, postoperative AKI occurred in 123 (24.0%) patients, in the Group 2 - in 94 patients (34.9%). As a result, both groups were divided in two subgroups - those with and without AKI. In Group 1, stage I AKI and transient AKI were significantly more frequently detected, and in the Group 2 - stage III AKI and persistent AKI. In both groups, the development of AKI was associated with a high rate of early cardiovascular events after CABG, and intergroup difference were revealed, especially in patients who did not have AKI. It is shown that the majority of parameters of MS were significantly higher in the Group 2 than in the Group 1 regardless the presence of the AKI. In-hospital mortality in both groups of patients with AKI was significantly higher than in patients without the AKI.
Conclusion. It is revealed that the presence of MS in patients undergoing coronary artery bypass grafting is associated with a high incidence of AKI and poor prognosis in immediate postoperative period.

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About the Autors


Information about the authors:
Iskenderov B.G. - Professor at the Department of Therapy, Cardiology and Functional Diagnostics SBEI FPE "Penza Institute of Advanced Training" of RMPH, MD
E-mail: iskenderovbg@mail.ru.
Sisina O.N. - Head of the Department of Nephrology SBEI FPE "Penza Institute of Advanced Training" of RMPH, Associate Professor, PhD in Medical Sciences.


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