Preoperative Serum Brain Natriuretic Peptide and Risk of Acute Kidney Injury After Cardiac Surgery
Key result
The highest quintile of preoperative BNP was associated with a significantly higher risk of at least mild postoperative acute kidney injury compared to the lowest quintile (RR 1.87; 95% CI 1.40-2.49).
Why the study?
Does preoperative BNP level predict postoperative acute kidney injury in adults undergoing cardiac surgery?
Population
1139 adults undergoing cardiac surgery selected for high acute kidney injury (AKI) risk
Comparison
Preoperative brain natriuretic peptide measurement vs Lowest preoperative BNP quintile
Design
Cohort
Follow-up
postoperative
Authors
Discussion
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Member takes
Implication
Preoperative BNP may refine AKI risk stratification in cardiac surgery patients; hypothesis-generating for BNP-guided interventions pending prospective trials.
Study Design
Type
Cohort (n=1,139)
Multicenter
Yes
Structured PICO
Does preoperative BNP level predict postoperative acute kidney injury in adults undergoing cardiac surgery?
P
Population
1,139 adults at high risk for acute kidney injury undergoing cardiac surgery across 6 hospitals.
E
Exposure
Preoperative brain natriuretic peptide (BNP) measurement (highest quintile)
C
Comparator
Lowest preoperative BNP quintile
O
Outcome
Postoperative acute kidney injury (AKI), defined as at least mild (≥0.3-mg/dL or 50% rise in creatinine) or severe (doubling of creatinine or requirement of acute renal replacement therapy)hard clinical
Main Result
Relative Risk: 1.87 (95% CI 1.4–2.49)
Preoperative BNP is a strong, independent predictor of postoperative AKI in high-risk patients undergoing cardiac surgery, modestly improving risk prediction over clinical parameters alone.
Limitations
- Findings need confirmation in other types of patients and surgeries
Cite This Study
Patel et al. (2012) conducted a cohort in Acute kidney injury after cardiac surgery (n=1,139). Highest quintile of preoperative brain natriuretic peptide (BNP) vs. Lowest quintile of preoperative BNP was evaluated on At least mild acute kidney injury (≥0.3-mg/dL or 50% rise in creatinine) (RR 1.87, 95% CI 1.40-2.49). The highest quintile of preoperative BNP was associated with a significantly higher risk of at least mild postoperative acute kidney injury compared to the lowest quintile (RR 1.87; 95% CI 1.40-2.49).