Cardiovascular Journal of Africa: Vol 32 No 6 (NOVEMBER/DECEMBER 2021)

CARDIOVASCULAR JOURNAL OF AFRICA • Volume 32, No 6, November/December 2021 AFRICA 311 Discussion AKI is an important factor affecting outcomes following Kaplan–Meier mortality estimates 0 0.25 0.00 0.50 0.75 1.00 50 100 Analysis time (days) 150 200 AKI = no AKI AKI = AKI Probability Fig. 2. Post-operative in-hospital survival probability curve in cardiac patients with and without cardiac surgery- associated acute kidney injury (CSA-AKI). Table 4. Demographic data of patients who underwent cardiac surgery on CPB, classified using KDIGO criteria Parameter KDIGO 0 ( n = 342) KDIGO 1 ( n = 96) KDIGO 2 ( n = 23) KDIGO 3 ( n = 16) p- value [mean (SD)/median (IQR)/ n (%)] [mean (SD)/median (IQR)/ n (%)] [mean (SD)/median (IQR)/ n (%)] [mean (SD)/median (IQR)/ n (%)] Age (years) 52 (38–61) 57 (42.5–63.5) 60 (50–63) 49 (30.5–39.5) 0.0299 BMI (kg/m 2 ) 2 2 (21.5–29.8) 26 (21–30) 26.7 (21.5–32.7) 26.2 (22.8–31.2) 0.840 Male gender 172 (50) 35 (36) 9 (39) 7 (44) 0.094 Diabetes mellitus 42 (12) 19 (18) 4 (17) 1 (6) 0.206 Hypertension 91 (27) 26 (27) 4 (17) 4 (25) 0.798 Mortality 18 (5) 13 (14) 8 (35) 7 (44) < 0.001 Hypercholesterolaemia 56 (16) 16 (17) 3 (13) 1 (6) 0.717 Smoking 58 (17) 16 (17) 5 (22) 4 (25) 0.795 Pre-operative eGFR (ml/min/1.73 m 2 ) 80.5 (6 1–98.1) 76.7 (57.3–89.9) 74.1 (48.8–89.9) 80.3 (66.6–92.6) 0.1278 eGFR < 15 2 (0.6) 2 (0.2) Nil Nil 0.0734 15–60 63 (18) 25 (27) 7 (30) 2 (12.5) 60–90 160 (47) 45 (47) 11 (48) 10 (63) > 90 116 (34) 23 (24) 5 (22) 4 (25) Pre-operative SCr (mg/dl) 1 (0.87–1.2) 1.1 (0.95–1.29) 1 (0.87–1.32) 0.98 (0.89–1.26) 0.0338 Cross-clamp time (min) 95 (71–120) 100 (78–128) 119 (84–171) 95 (90–124) 0.1414 CPB time (min) 144 (114–178) 153 (121–192) 174 (124–239) 158.5 (118–250) 0.1554 IABP 6 (2) 10 (10) 2 (9) 1 (6) 0.001 VAD 2 (0.6) Nil Nil Nil 0.851 ECMO 8 (2) 6 (6) 2 (9) 5 (31) < 0.001 Lowest temperaure 32 (30–32) 30 (30–32) 32 (30–32) 31 (30–32) 0.6142 SCr change from baseline Day 1 0.94 (0.78–1.1) 1.2 (0.98–1.39) 1.24 (1–1.59) 1.4 (1.2–2.0) 0.0001 Day 2 0.97 (0.76–1.15) 1.4 (1.18–1.74) 1.69 (1.39–2.17) 1.76 (1.4–2.6) 0.0001 Day 3 0.87 (0.71–1.06) 1.4 (1–1.67) 1.79 (1.58–2.4) 2.6 (1.86–3.72) 0.0001 Day 4 0.81 (0.63–0.98) 1.2 (0.95–1.64) 1.5 (1.2–2.39) 3.0 (2.5–4.2) 0.0001 Day 5 0.78 (0.59–0.96) 1 (0.89–1.48) 1.6 (1–2.64) 3.0 (2.38–3.4) 0.0001 Day 6 0.78 (0.55–0.96) 1 (0.79–1.44) 1.6 (0.88–2.5) 2.8 (2–3.98) 0.0001 Day 7 0.8 (0.6–1) 1 (0.78–1.4) 1.3 (0.98–2) 2.8 (1.67–4.4) 0.0001 Type of cardiac surgery CABG 111 (66) 40 (24) 8 (5) 8 (5) 0.155 Valve 187 (75) 48 (19) 10 (4) 5 (2) Aortic 12 (70) 4 (24) Nil 1 (6) Other 32 (74) 4 (9) 5 (12) 2 (5) RRT Nil 3 (3) Nil Nil 0.007 BMI, body mass index; IABP, intra-aortic balloon pump; VAD, ventricular assist device; ECMO, extracorporeal membrane oxygenator; eGFR, estimated glomerular filtration rate; SCr, serum creatinine; CABG, coronary artery bypass graft; RRT, renal replacement therapy. Table 5. Logistic regression analysis of factors associated with CSA-AKI Predictors of CSA-AKI (n = 135) Unadjusted logistic regression analysis Adjusted logistic regression analysis UOR (95% CI) p -value AOR (95% CI) p -value Age 1.02 (1.00–1.03) 0.024 1.02 (0.99–1.03) 0.052 Female gender 0.60 (0.40–0.91) 0.017 0.58 (0.36–0.93) 0.025 African race 1.51 (1.01– 2.25) 0.044 1.12 (0.66–1.88) 0.676 ECMO 4.42 (1.79–10.93) 0 .001 3.05 (1.11–8.39) 0.030 IABP 93 (2.21–1 95) < 0 .001 3.78 (1.29–11.03) 0. 015 CPB time (min) 1.00 (1.00–1.01) 0.036 1.00 (0.99–1.04) 0.363 Baseline SCr 1.01 (0.89–1.15) 0.853 0.95 (0.77–1.19) 0.675 Pre-operative eGFR 0.99 (0.98–0.99) 0.010 0.99 (0.98–1.01) 0.253 Hypertension 0.92 (0.58–1.45) 0.724 0.53 (0.29–0.97) 0.041 Diabetes mellitus 1.54 (0.89–2.66) 0.122 1.69 (0.86–3.33) 0.126 Smoking 1.11 (0.66–1.86) 0.696 0.79 (0.43–1.45) 0.448 UOR, unadjusted odds ratio; AOR, adjusted odds ratio; SCr, serum creatinine; CI, confidence interval; ECMO, extracorporeal membrane oxygenator; IABP, intra-aortic balloon pump.