The choice of the modality of the renal replacement therapy after cardiac surgery based on the prognosis of poor outcome
Abstract
The aim. Identification of the criteria for choice of the modality of renal replacement therapy (RRT) after cardiac surgery with cardiopulmonary bypass (CPB). Materials and methods. A single-center retrospective cohort study was performed to evaluate some demographic and clinical parameters as the potential risk factors for poor outcome in patients with AKI requiring RRT (AKI-D) after cardiac surgery with CPB. Original severity score was developed and a criterion was made for choice of renal replacement therapy modality. Results. Developed score had the best discriminatory ability for death predicting in patients with AKI-D after cardiac surgery with CPB. The area under the receiver operating characteristic (ROC) curve for the score was 0,892 (95% CI 0,852 to 0,925). Its predictive accuracy was compared with other scores by area under the ROC curve. After applying the new score to the group of patients on intermittent hemodialysis (IHD) a defined criterion for the choice of RRT modality was developed. The value of the new score of 3,2 and below was found to be safe for the choice of intermittent hemodialysis modality. Conclusions. The new score is valid and accurate in predicting death for AKI-D after open-heart surgery. This score and value for the choice of RRT was made for guidance only, but in difficult situations, this score can facilitate the choice.
About the Authors
A. A. Malov
State Research Institute of Circulation Pathology Novosibirsk, Russian Federation
Russian Federation
Russian Federation
T. V. Mukhoedova
State Research Institute of Circulation Pathology Novosibirsk, Russian Federation
Russian Federation
Russian Federation
A. S. Borisov
State Research Institute of Circulation Pathology Novosibirsk, Russian Federation
Russian Federation
Russian Federation
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For citations:
Malov A.A., Mukhoedova T.V., Borisov A.S. The choice of the modality of the renal replacement therapy after cardiac surgery based on the prognosis of poor outcome. Nephrology and Dialysis. 2014;16(1):155-161. (In Russ.)
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