Key result
Preoperative vitamin D levels show no association with AKI following open heart surgery.
Why the study?
The relationship between preoperative 25-Hydroxy Vitamin D levels and acute kidney injury after cardiopulmonary bypass in open heart surgery patients was unclear.
Does preoperative vitamin D level predict acute kidney injury in patients undergoing open heart surgery with cardiopulmonary bypass?
Cohort (n=97)
No
Does preoperative vitamin D level predict acute kidney injury in patients undergoing open heart surgery with cardiopulmonary bypass?
Preoperative vitamin D levels were not significantly associated with the development of acute kidney injury after open heart surgery with cardiopulmonary bypass.
Preoperative vitamin D was not associated with post-CPB AKI; leaves open any predictive role for prospective evaluation.
Objective: In this study, the relationship between acute kidney injury (AKI) that developed in the early postoperative period in the patients that underwent open heart surgery with cardiopulmonary bypass (CPB) and their preoperative 25-Hydroxy Vitamin D (25-OHD) levels was investigated. Method: 285 patients who underwent open heart surgery with CPB between February 2018 and December 2020 were retrospectively analyzed. Ninety seven patients (71 men, 26 women) who met the criteria were included in the study. The patients were divided into 3 groups according to their preoperative 25-OHD levels as deficiency (group I, n=28), insufficiency (group II, n=42) and normal (group III, n=27).Demographic and clinical characteristics, AKI, and CPB time were compared between the groups.Kidney Disease: Improving Global Outcomes (KDIGO) guidelines were used to define postoperative AKI. Results: According to the KDIGO guidelines, the incidence of postoperative AKI decreased to 19% at the end of 48 hours and to 6.2% at discharge whereas it was 21% in the first 24 hours. The decrease in KDIGO AKI stages was found to be statistically significant (p=0.002). The rate of DM was found to be significantly higher in Group I (p=0.001). No statistical difference was found between AKI and 25-OHD levels at 24 hours, 48 hours and discharge. CPB time was found to be significantly higher in Group I (p=0.006). In the univariate logistic regression model created after 25-OHD groups were taken as low (group I+group II) and normal (group III), low 25-OHD levels were found to have a significant effect on the development of DM (p=0.001, OR:8.474, 95%CI 2.336 -30.303). Conclusion: Although we could not find a statistical relationship between AKI and preoperative 25-OHD levels in the patients that underwent open heart surgery with CPB, we believe that 25-OHD deficiency might have effects on postoperative morbidity and mortality by affecting the renocardiovascular system.
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Çelik et al. (2022) conducted a cohort in Acute kidney injury after cardiopulmonary bypass (n=97). Preoperative 25-Hydroxy Vitamin D (25-OHD) deficiency or insufficiency vs. Normal preoperative 25-OHD levels (≥20-80 ng/dl) was evaluated on Postoperative acute kidney injury (AKI) according to KDIGO guidelines. Preoperative 25-Hydroxy Vitamin D levels showed no significant association with the development of acute kidney injury at 24 hours, 48 hours, or discharge in patients undergoing open heart surgery with cardiopulmonary bypass.
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