Association of early postoperative serum magnesium with acute kidney injury after cardiac surgery

Introduction Dysmagnesemia has been demonstrated to be involved in the pathophysiology of kidney diseases and is common in cardiac surgical patients. It remains unknown whether changes of serum magnesium after cardiac surgery affect AKI. We aimed to investigate the association of early postoperative...

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Main Authors: Chao Xiong, Sheng Shi, Liang Cao, Hongbai Wang, Lijuan Tian, Yuan Jia, Min Zeng, Jianhui Wang
Format: Article
Language:English
Published: Taylor & Francis Group 2023-12-01
Series:Renal Failure
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Online Access:https://www.tandfonline.com/doi/10.1080/0886022X.2023.2170244
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author Chao Xiong
Sheng Shi
Liang Cao
Hongbai Wang
Lijuan Tian
Yuan Jia
Min Zeng
Jianhui Wang
author_facet Chao Xiong
Sheng Shi
Liang Cao
Hongbai Wang
Lijuan Tian
Yuan Jia
Min Zeng
Jianhui Wang
author_sort Chao Xiong
collection DOAJ
description Introduction Dysmagnesemia has been demonstrated to be involved in the pathophysiology of kidney diseases and is common in cardiac surgical patients. It remains unknown whether changes of serum magnesium after cardiac surgery affect AKI. We aimed to investigate the association of early postoperative magnesium with cardiac surgery-associated AKI in adults.Methods We conducted a multicenter retrospective cohort study involving patients who underwent cardiac surgery in the eICU Collaborative Research Database between 2014 and 2015. AKI within 7 days after surgery was defined using both serum creatinine and urine output criteria of Kidney Disease Improving Global Outcomes definition. Postoperative AKI was analyzed using multivariable logistic regression with early postoperative serum magnesium measured within the first 24 h after surgery as a continuous variable and categorically by quartiles.Results Postoperative AKI was identified in 3498 of 6124 (57.1%) patients receiving cardiac surgery. The median (25th–75th percentiles) early postoperative serum magnesium level of the study population was 2.3 (2.0–2.7) mg/dL. Higher serum magnesium level was associated with a higher risk of developing postoperative AKI (adjusted odds ratio (OR), 1.46 per 1 mg/dL increase; 95% confidence interval (CI), 1.31–1.62; p<.001). The multivariable-adjusted ORs (95% CIs) of postoperative AKI across increasing quartiles of serum magnesium were 1.00 (referent), 1.11 (0.95–1.29), 1.30 (1.12–1.52), and 1.72 (1.47–2.02) (p for trend <.001).Conclusions These data demonstrate a significantly higher incidence of AKI in patients with higher early postoperative serum magnesium who underwent cardiac surgery.
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spelling doaj-art-949818f59b0f4e2cbc172a9d11c880242025-08-20T02:28:53ZengTaylor & Francis GroupRenal Failure0886-022X1525-60492023-12-0145110.1080/0886022X.2023.2170244Association of early postoperative serum magnesium with acute kidney injury after cardiac surgeryChao Xiong0Sheng Shi1Liang Cao2Hongbai Wang3Lijuan Tian4Yuan Jia5Min Zeng6Jianhui Wang7Department of Anesthesiology, National Center of Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaDepartment of Anesthesiology, National Center of Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaDepartment of Anesthesiology, National Center of Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaDepartment of Anesthesiology, National Center of Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaDepartment of Anesthesiology, National Center of Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaDepartment of Anesthesiology, National Center of Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaCenter for Pediatric Cardiac Surgery, National Center of Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaDepartment of Anesthesiology, National Center of Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaIntroduction Dysmagnesemia has been demonstrated to be involved in the pathophysiology of kidney diseases and is common in cardiac surgical patients. It remains unknown whether changes of serum magnesium after cardiac surgery affect AKI. We aimed to investigate the association of early postoperative magnesium with cardiac surgery-associated AKI in adults.Methods We conducted a multicenter retrospective cohort study involving patients who underwent cardiac surgery in the eICU Collaborative Research Database between 2014 and 2015. AKI within 7 days after surgery was defined using both serum creatinine and urine output criteria of Kidney Disease Improving Global Outcomes definition. Postoperative AKI was analyzed using multivariable logistic regression with early postoperative serum magnesium measured within the first 24 h after surgery as a continuous variable and categorically by quartiles.Results Postoperative AKI was identified in 3498 of 6124 (57.1%) patients receiving cardiac surgery. The median (25th–75th percentiles) early postoperative serum magnesium level of the study population was 2.3 (2.0–2.7) mg/dL. Higher serum magnesium level was associated with a higher risk of developing postoperative AKI (adjusted odds ratio (OR), 1.46 per 1 mg/dL increase; 95% confidence interval (CI), 1.31–1.62; p<.001). The multivariable-adjusted ORs (95% CIs) of postoperative AKI across increasing quartiles of serum magnesium were 1.00 (referent), 1.11 (0.95–1.29), 1.30 (1.12–1.52), and 1.72 (1.47–2.02) (p for trend <.001).Conclusions These data demonstrate a significantly higher incidence of AKI in patients with higher early postoperative serum magnesium who underwent cardiac surgery.https://www.tandfonline.com/doi/10.1080/0886022X.2023.2170244Acute kidney injurycardiac surgerymagnesiumeICU
spellingShingle Chao Xiong
Sheng Shi
Liang Cao
Hongbai Wang
Lijuan Tian
Yuan Jia
Min Zeng
Jianhui Wang
Association of early postoperative serum magnesium with acute kidney injury after cardiac surgery
Renal Failure
Acute kidney injury
cardiac surgery
magnesium
eICU
title Association of early postoperative serum magnesium with acute kidney injury after cardiac surgery
title_full Association of early postoperative serum magnesium with acute kidney injury after cardiac surgery
title_fullStr Association of early postoperative serum magnesium with acute kidney injury after cardiac surgery
title_full_unstemmed Association of early postoperative serum magnesium with acute kidney injury after cardiac surgery
title_short Association of early postoperative serum magnesium with acute kidney injury after cardiac surgery
title_sort association of early postoperative serum magnesium with acute kidney injury after cardiac surgery
topic Acute kidney injury
cardiac surgery
magnesium
eICU
url https://www.tandfonline.com/doi/10.1080/0886022X.2023.2170244
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