Key result
Time on cardiopulmonary bypass was not independently associated with acute renal failure requiring dialysis after adjusting for confounders, despite a univariate OR of 3.84 (95% CI 2.58-5.7).
Why the study?
Does longer time on cardiopulmonary bypass increase the risk of acute renal failure requiring dialysis in patients undergoing cardiac surgery?
Observational (n=11,092)
Does longer time on cardiopulmonary bypass increase the risk of acute renal failure requiring dialysis in patients undergoing cardiac surgery?
Time on cardiopulmonary bypass is not an independent predictor of acute renal failure requiring dialysis after adjusting for confounders, suggesting baseline patient risk assessment is more critical.
CPB time does not independently predict dialysis-requiring acute renal failure after cardiac surgery; leaves open its role in unadjusted or high-risk subgroups.
It is commonly accepted that the longer the time on extracorporeal cardiopulmonary bypass (CPB), the higher is the likelihood of developing acute renal failure requiring dialysis (ARF-D). Nonetheless, previous works elicited conflicting evidence. We investigated the relationship between CPB duration and ARF-D occurrence. Data were extracted from a large observational study. All factors independently associated with ARF-D were detected. Overall, 11,092 case record forms were analyzed. At the univariate analyses, time on CBP was associated with an increase in the ARF-D risk (odds ratio of fifth vs. first quintile of CBP time: 3.84; 95% confidence interval: 2.58-5.7; P < 0.001). However, after adjusting for confounders, the association between time on CBP and ARF-D lost its statistical significance. In this large dataset, CBP time did not predict ARF-D occurrence. These results might suggest that an accurate risk assessment might be more important than time on CPB in determining ARF-D occurrence.
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Caramelli et al. (2011) conducted an observational in Cardiac surgery (n=11,092). Time on cardiopulmonary bypass vs. Shorter time on cardiopulmonary bypass (first quintile) was evaluated on Acute renal failure requiring dialysis (ARF-D) (OR 3.84, 95% CI 2.58-5.7, p=<0.001). Time on cardiopulmonary bypass was not independently associated with acute renal failure requiring dialysis after adjusting for confounders, despite a univariate OR of 3.84 (95% CI 2.58-5.7).
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