Preoperative Proteinuria Predicts Adverse Renal Outcomes after Coronary Artery Bypass Grafting

• DOI: 10.1681/asn.2010050553
• Publication Date: 2010-11-30T05:09:12Z
• Authors: Tao-Min Huang; Vin-Cent Wu; Guang-Huar Young; Yu-Feng Lin; Chih-Chung Shiao; Pei-Chen Wu; Wen-Yi Li; Hsi-Yu Yu; Fu-Chang Hu; Jou-Wei Lin; Yih-Sharng Chen; Yen-Hung Lin; Shoei-Shen Wang; Ron-Bin Hsu; Fan-Chi Chang; Nai-Kuan Chou; Tzong-Shinn Chu; Yu-Chang Yeh; Pi-Ru Tsai; Jenq-Wen Huang; Shuei-Liong Lin; Yung-Ming Chen; Wen-Je Ko; Kwan-Dun Wu
• Keywords: Male; Acute Kidney Injury; Middle Aged; Kidney; 3. Good health; Cohort Studies; Renal Replacement Therapy; Proteinuria; 03 medical and health sciences; 0302 clinical medicine; Predictive Value of Tests; Risk Factors; Preoperative Period; Humans; Female; Prospective Studies; Coronary Artery Bypass; Aged; Glomerular Filtration Rate; Retrospective Studies

Whether preoperative proteinuria associates with adverse renal outcomes after cardiac surgery is unknown. Here, we performed a secondary analysis of a prospectively enrolled cohort of adult patients undergoing coronary artery bypass grafting (CABG) at a medical center and its two affiliate hospitals between 2003 and 2007. We excluded patients with stage 5 CKD or those who received dialysis previously. We defined proteinuria, measured with a dipstick, as mild (trace to 1+) or heavy (2+ to 4+). Among a total of 1052 patients, cardiac surgery-associated acute kidney injury (CSA-AKI) developed in 183 (17.4%) patients and required renal replacement therapy (RRT) in 50 (4.8%) patients. In a multiple logistic regression model, mild and heavy proteinuria each associated with an increased odds of CSA-AKI, independent of CKD stage and the presence of diabetes mellitus (mild: OR 1.66, 95% CI 1.09 to 2.52; heavy: OR 2.30, 95% CI 1.35 to 3.90). Heavy proteinuria also associated with increased odds of postoperative RRT (OR 7.29, 95% CI 3.00 to 17.73). In summary, these data suggest that preoperative proteinuria is a predictor of CSA-AKI among patients undergoing CABG.