Evaluation of the incidence of acute kidney injury following coronary artery bypass graft surgery

Document Type : Original Article


1 Department of Cardiovascular Surgery, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

2 Student Research Committee, Faculty of Medicine, Islamic Azad University, Mashhad Branch, Mashhad, Iran

3 Razavi Cancer Research Center, Razavi Hospital, Imam Reza International University, Mashhad, Iran

4 Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.


Introduction: Coronary artery bypass grafting (CABG) is one of the most common surgical methods in patients with coronary artery disease, a well-known complication of which is renal injury after surgery. Here we try to understand the factors involved in the incidence of acute renal injury in our patients.
Objective: The aim of this study was to evaluate the incidence and etiology of acute kidney injury (AKI) following CABG.
Methods: This study was performed on 181 patients undergoing CABG surgery. AKI was also recorded after registering demographic information and clinical indications. Chi-square, Mann-Whitney and independent t-tests were used for data comparison.
Results: The findings of our study showed that AKI following CABG in our patients was 3.9% which had no significant relationship with age, sex, hypertension, diabetes, type of surgery, hypercholesterolemia, number of clogged arteries, smoking and length of surgery; however,blood, urea was found to be significantly higher preoperatively in patients with AKI.
Conclusion: The results of our study revealed that AKI following CABG in the studied patients was 3.9%, which was not significantly related to age, sex, hypertension, diabetes, type of surgery, hypercholesterolemia, number of clogged vessels, smoking and the length of surgery. although, the urea was observed to be significantly higher in patients with AKI before surgery. Studies with larger sample sizes are recommended.


1.Weinstein MC, Coxson PG, Williams LW, Pass TM,
Stason WB, Goldman L. Forecasting coronary heart
disease incidence, mortality, and cost: the Coronary
Heart Disease Policy Model. Am J Public Health. 1987
2. Delahaye F, Roth O, de Gevigney G. Epidemiology of
acute coronary syndrome. Rev Prat. 2003; 53(6):607-10.
3.Brown JR, Kramer RS, Coca SG, Parikh CR. Duration
of acute kidney injury impacts long-term survival after
cardiac surgery. Ann Thorac Surg. 2010;90(4):1142-8.
4.Vellinga S, Verbrugghe W, De Paep R, Verpooten G,
Janssen van Doorn K. Identification of modifiable risk
factors for acute kidney injury after cardiac surgery.
Neth J Med. 2012;70(10):450-4.
5.Gude D, Jha R. Acute kidney injury following cardiac
surgery. Ann Card Anaesth. 2012;15(4):279-86.
6.Karkouti K, Wijeysundera DN, Yau TM, Callum JL,
Cheng DC, Crowther M, et al. Acute kidney injury after
cardiac surgery: focus on modifiable risk factors.
Circulation. 2009;119(4):495-502.
7.Mao MA, Thongprayoon C, Wu Y, Tejwani V, VelaOrtiz M, Dearani J, et al. Incidence, severity, and
outcomes of acute kidney injury in octogenarians
following heart valve replacement surgery. Int J
Nephrol. 2015;2015:237951.
8.Coppolino G, Presta P, Saturno L, Fuiano G. Acute
kidney injury in patients undergoing cardiac surgery. J
Nephrol. 2013;26(1):32-40
9.Freeland K, Jahromi AH, Duvall LM, Mancini MC.
Postoperative blood transfusion is an independent
predictor of acute kidney injury in cardiac surgery
patients. J Nephropathol. 2015;4(4):121-6.
10. Ried M, Puehler T, Haneya A, Schmid C, Diez C.
Acute kidney injury in septua- and octogenarians after
cardiac surgery. BMC Cardiovasc Disord. 2011;11(1):52
11.Hu Y, Li Z, Chen J, Shen C, Song Y, Zhong Q. The
effect of the time interval between coronary angiography
and on-pump cardiac surgery on risk of postoperative
acute kidney injury: a meta-analysis. J Cardiothorac
Surg. 2013;8(1):178.
12.Chen SW, Chang CH, Fan PC, Chen YC, Chu PH,
Chen TH, et al. Comparison of contemporary
preoperative risk models at predicting acute kidney
injury after isolated CABGing: a retrospective cohort
study. BMJ Open. 2016;6(6):e010176.
13. Li XH, Xiao F, Zhang SY. Investigation of risk
factors of acute kidney injury after off-pump ing and 3
years' follow-up. Beijing Da Xue Xue Bao Yi Xue Ban.
14.Oezkur M, Wagner M, Weismann D, Krannich JH,
Schimmer C, Riegler C, et al. Chronic hyperglycemia is
associated with acute kidney injury in patients
undergoing CABG surgery: a cohort study. BMC
Cardiovasc Disord. 2015;15(1):41.
15.Spunda R, Valek M, Salmay M, Prskavec T, Pecha O,
Lindner J, et al. Differential impact on acute kidney
injury incidence between on-and off pump coronary
artery bypass grafting in octogenarians. Biomed Pap
Med Fac Univ Palacky Olomouc Czech Repub.
16.Thakar CV, Liangos O, Yared JP, Nelson D,
Piedmonte MR, Hariachar S, et al. ARF after open-heart
surgery: Influence of gender and race. Am J Kidney Dis.
2003 Apr;41(4):742-51.
17. Schopka S, Diez C, Camboni D, Floerchinger B,
Schmid C, Hilker M. Impact of cardiopulmonary bypass
on acute kidney injury following coronary artery bypass

Mottahedi B et al.
4 Razavi Int J Med. 2022; 10(3):e1204.
grafting: a matched pair analysis. J Cardiothorac Surg.
2014 Jan 18;9:20.
18. Kumada Y, Yoshitani K, Shimabara Y, Ohnishi Y.
Perioperative risk factors for acute kidney injury after
off-pump coronary artery bypass grafting: a retrospective
study. JA Clin Rep. 2017;3(1):55.
19. Ghanei E, Hogat SA, Orouji Jokar T, Kolahi AA.
Coronary Artery Bypass Surgery and Acute Kidney
Injury: Impact of the Off-Pump Technique. Iran Red
Crescent J. 2012; 14(2): 65-9.
20. Onk OA, Onk D, Ozcelik F, Gunay M, Turkmen K.
Risk Factors for Acute Kidney Injury after Coronary
Artery Bypass Surgery and Its Detection Using
Neutrophil Gelatinase-Associated Lipocalin. Cardiorenal
Med. 2016 May;6(3):216-29.
21.Kakili H, Gachkar L. Check cystatin c and efficiency
cut-off point for the diagnosis of coronary artery disease
in patients admitted for elective coronary angiography
artery in Modares hospital in 2013. Medical Thesis.
22.Pournosrat K, Soleimannejad K, Yaghmaei P. The
Inflammatory Role of Myeloperoxidase and Its Increased
Level in Patients with Coronary Artery Disease. sjimu.
2014; 22 (5) :168-178
23.Deb, S; Wijeysundera, HC; Ko, DT; Tsubota, H; Hill,
S; Fremes, SE. Coronary artery bypass graft surgery vs
percutaneous interventions in coronary revascularization:
a systematic review. JAMA 2013; 310 (19): 2086–
95.doi:10.1001/jama.2013.281718. PMID 24240936.