Predictability of kinetic estimated glomerular filtration rate for acute kidney injury in patients undergoing coronary artery bypass surgery
Abstract Background Acute kidney injury (AKI) is a serious complication of coronary artery bypass grafting (CABG). This study aimed to assess the efficacy of kinetic estimated glomerular filtration rate (KeGFR) in predicting AKI in patients undergoing CABG. Additionally, we sought to identify potent...
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BMC
2025-07-01
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| Series: | BMC Nephrology |
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| Online Access: | https://doi.org/10.1186/s12882-025-04266-1 |
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| author | Mohammad Ali Haghighatpanah Sadegh Mazaheri-Tehrani Amirhosein Adibzadeh Negar Ostadsharif Parham Moradi Mahshad Vali Roya Riahi Mohsen Mirmohammadsadeghi |
| author_facet | Mohammad Ali Haghighatpanah Sadegh Mazaheri-Tehrani Amirhosein Adibzadeh Negar Ostadsharif Parham Moradi Mahshad Vali Roya Riahi Mohsen Mirmohammadsadeghi |
| author_sort | Mohammad Ali Haghighatpanah |
| collection | DOAJ |
| description | Abstract Background Acute kidney injury (AKI) is a serious complication of coronary artery bypass grafting (CABG). This study aimed to assess the efficacy of kinetic estimated glomerular filtration rate (KeGFR) in predicting AKI in patients undergoing CABG. Additionally, we sought to identify potential factors contributing to the occurrence of AKI. Methods This retrospective cohort study was conducted at Shahid Chamran Specialty Heart Hospital in Isfahan, Iran, among patients undergoing CABG between November 2018 and May 2021. The baseline eGFR of the patients was calculated using the Modification of Diet in Renal Disease (MDRD) formula. Postoperatively, renal function was assessed using the KeGFR equation. The percentage decrease in KeGFR after surgery compared to baseline eGFR was utilized to evaluate its predictive ability for AKI incidence during hospitalization. According to KDIGO criteria, participants were divided into AKI and non-AKI groups. Results Among 558 included individuals (81.2% male), 186 patients (33.3%) were diagnosed with AKI during hospitalization. Patients with AKI were older and had more comorbidities like hypertension, heart failure, and anemia compared to those without AKI. Additionally, AKI cases exhibited higher rates of blood product transfusions, longer intubation periods, and extended intensive care unit (ICU) stays. The percentage decrease in KeGFR from baseline demonstrated acceptable accuracy in predicting AKI cases (AUC (95%CI): 0.808 (0.753 to 0.864)). Risk factors for AKI in our population included age over 65, smoking, and prolonged intubation time. We found that patients with higher values of neutrophil-lymphocyte-platelet ratio (NLPR) had an increased risk of developing AKI compared to those with lower values (OR: 1.74; 95%CI: 1.07 to 2.83). Conclusion KeGFR demonstrated desirable predictive accuracy for AKI incidence following CABG. Meanwhile, NLPR emerged as a new clinically useful biomarker for monitoring renal function post-CABG. Further prospective investigations are recommended in different settings and other cardiac operations. Trial registration Clinical trial number not applicable. |
| format | Article |
| id | doaj-art-eac4cb7f599d44ceaba1718d0b7842b0 |
| institution | Kabale University |
| issn | 1471-2369 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | BMC |
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| series | BMC Nephrology |
| spelling | doaj-art-eac4cb7f599d44ceaba1718d0b7842b02025-08-20T03:45:51ZengBMCBMC Nephrology1471-23692025-07-0126111010.1186/s12882-025-04266-1Predictability of kinetic estimated glomerular filtration rate for acute kidney injury in patients undergoing coronary artery bypass surgeryMohammad Ali Haghighatpanah0Sadegh Mazaheri-Tehrani1Amirhosein Adibzadeh2Negar Ostadsharif3Parham Moradi4Mahshad Vali5Roya Riahi6Mohsen Mirmohammadsadeghi7Department of Cardiovascular Surgery, Chamran Heart Center, Isfahan University of Medical SciencesChild Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical SciencesStudent Research Committee, School of Medicine, Isfahan University of Medical SciencesStudent Research Committee, School of Medicine, Isfahan University of Medical SciencesSchool of Medicine, Shahrekord University of Medical SciencesSchool of Medicine, Isfahan University of Medical SciencesDepartment of Epidemiology and Biostatistics, School of Public Health, Isfahan University of Medical SciencesDepartment of Cardiovascular Surgery, Chamran Heart Center, Isfahan University of Medical SciencesAbstract Background Acute kidney injury (AKI) is a serious complication of coronary artery bypass grafting (CABG). This study aimed to assess the efficacy of kinetic estimated glomerular filtration rate (KeGFR) in predicting AKI in patients undergoing CABG. Additionally, we sought to identify potential factors contributing to the occurrence of AKI. Methods This retrospective cohort study was conducted at Shahid Chamran Specialty Heart Hospital in Isfahan, Iran, among patients undergoing CABG between November 2018 and May 2021. The baseline eGFR of the patients was calculated using the Modification of Diet in Renal Disease (MDRD) formula. Postoperatively, renal function was assessed using the KeGFR equation. The percentage decrease in KeGFR after surgery compared to baseline eGFR was utilized to evaluate its predictive ability for AKI incidence during hospitalization. According to KDIGO criteria, participants were divided into AKI and non-AKI groups. Results Among 558 included individuals (81.2% male), 186 patients (33.3%) were diagnosed with AKI during hospitalization. Patients with AKI were older and had more comorbidities like hypertension, heart failure, and anemia compared to those without AKI. Additionally, AKI cases exhibited higher rates of blood product transfusions, longer intubation periods, and extended intensive care unit (ICU) stays. The percentage decrease in KeGFR from baseline demonstrated acceptable accuracy in predicting AKI cases (AUC (95%CI): 0.808 (0.753 to 0.864)). Risk factors for AKI in our population included age over 65, smoking, and prolonged intubation time. We found that patients with higher values of neutrophil-lymphocyte-platelet ratio (NLPR) had an increased risk of developing AKI compared to those with lower values (OR: 1.74; 95%CI: 1.07 to 2.83). Conclusion KeGFR demonstrated desirable predictive accuracy for AKI incidence following CABG. Meanwhile, NLPR emerged as a new clinically useful biomarker for monitoring renal function post-CABG. Further prospective investigations are recommended in different settings and other cardiac operations. Trial registration Clinical trial number not applicable.https://doi.org/10.1186/s12882-025-04266-1Coronary artery bypassCardiac surgical proceduresAcute kidney injuryGlomerular filtration rateKinetic estimated glomerular filtration rate |
| spellingShingle | Mohammad Ali Haghighatpanah Sadegh Mazaheri-Tehrani Amirhosein Adibzadeh Negar Ostadsharif Parham Moradi Mahshad Vali Roya Riahi Mohsen Mirmohammadsadeghi Predictability of kinetic estimated glomerular filtration rate for acute kidney injury in patients undergoing coronary artery bypass surgery BMC Nephrology Coronary artery bypass Cardiac surgical procedures Acute kidney injury Glomerular filtration rate Kinetic estimated glomerular filtration rate |
| title | Predictability of kinetic estimated glomerular filtration rate for acute kidney injury in patients undergoing coronary artery bypass surgery |
| title_full | Predictability of kinetic estimated glomerular filtration rate for acute kidney injury in patients undergoing coronary artery bypass surgery |
| title_fullStr | Predictability of kinetic estimated glomerular filtration rate for acute kidney injury in patients undergoing coronary artery bypass surgery |
| title_full_unstemmed | Predictability of kinetic estimated glomerular filtration rate for acute kidney injury in patients undergoing coronary artery bypass surgery |
| title_short | Predictability of kinetic estimated glomerular filtration rate for acute kidney injury in patients undergoing coronary artery bypass surgery |
| title_sort | predictability of kinetic estimated glomerular filtration rate for acute kidney injury in patients undergoing coronary artery bypass surgery |
| topic | Coronary artery bypass Cardiac surgical procedures Acute kidney injury Glomerular filtration rate Kinetic estimated glomerular filtration rate |
| url | https://doi.org/10.1186/s12882-025-04266-1 |
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