Association of Pre-Operative Albuminuria with Post-Operative Outcomes after Coronary Artery Bypass Grafting

Lekha George, Miklos Z. Molnar, Jun L. Lu, Kamyar Kalantar-Zadeh, Santhosh Koshy, Csaba Kovesdy

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

The effect on post-operative outcomes after coronary artery bypass graft(CABG) surgery is not clear. Among 17,812 patients who underwent CABG during October 1,2006-September 28,2012 in any Department of US Veterans Affairs(VA) hospital, we identified 5,968 with available preoperative urine albumin-creatinine ratio(UACR) measurements. We examined the association of UACR<30, 30-299 and >=300 mg/g with 30/90/180/365-day and overall all-cause mortality, and hospitalization length >10 days, and with acute kidney injury(AKI). Mean ± SD baseline age and eGFR were 66 ± 8 years and 77 ± 19 ml/min/1.73 m2, respectively. 788 patients(13.2%) died during a median follow-up of 3.2 years, and 26.8% patients developed AKI(23.1%-Stage 1; 2.9%-Stage 2; 0.8%-Stage 3) within 30 days of CABG. The median lengths of stay were 8 days(IQR: 6-13 days), 10 days(IQR: 7-14 days) and 12 days(IQR: 8-19 days) for groups with UACR < 30 mg/g, 30-299 mg/g and ≥300 mg/g, respectively. Higher UACR conferred 72 to 85% higher 90-, 180-, and 365-day mortality compared to UACR <30 mg/g (odds ratio and 95% confidence interval for UACR ≥ 300 vs. <30 mg/g: 1.72(1.01-2.95); 1.85(1.14-3.01); 1.74(1.15-2.61), respectively). Higher UACR was also associated with significantly longer hospitalizations and higher incidence of all stages of AKI. Higher UACR is associated with significantly higher odds of mortality, longer post-CABG hospitalization, and higher AKI incidence.

Original languageEnglish (US)
Article number16458
JournalScientific reports
Volume5
DOIs
StatePublished - Nov 9 2015

Fingerprint

Albuminuria
Coronary Artery Bypass
Albumins
Creatinine
Urine
Acute Kidney Injury
Transplants
Hospitalization
Mortality
Veterans Hospitals
Incidence
Length of Stay
Odds Ratio
Confidence Intervals

All Science Journal Classification (ASJC) codes

  • General

Cite this

Association of Pre-Operative Albuminuria with Post-Operative Outcomes after Coronary Artery Bypass Grafting. / George, Lekha; Molnar, Miklos Z.; Lu, Jun L.; Kalantar-Zadeh, Kamyar; Koshy, Santhosh; Kovesdy, Csaba.

In: Scientific reports, Vol. 5, 16458, 09.11.2015.

Research output: Contribution to journalArticle

@article{6f238958f3fe4ce6b9e6597ba10f7eae,
title = "Association of Pre-Operative Albuminuria with Post-Operative Outcomes after Coronary Artery Bypass Grafting",
abstract = "The effect on post-operative outcomes after coronary artery bypass graft(CABG) surgery is not clear. Among 17,812 patients who underwent CABG during October 1,2006-September 28,2012 in any Department of US Veterans Affairs(VA) hospital, we identified 5,968 with available preoperative urine albumin-creatinine ratio(UACR) measurements. We examined the association of UACR<30, 30-299 and >=300 mg/g with 30/90/180/365-day and overall all-cause mortality, and hospitalization length >10 days, and with acute kidney injury(AKI). Mean ± SD baseline age and eGFR were 66 ± 8 years and 77 ± 19 ml/min/1.73 m2, respectively. 788 patients(13.2{\%}) died during a median follow-up of 3.2 years, and 26.8{\%} patients developed AKI(23.1{\%}-Stage 1; 2.9{\%}-Stage 2; 0.8{\%}-Stage 3) within 30 days of CABG. The median lengths of stay were 8 days(IQR: 6-13 days), 10 days(IQR: 7-14 days) and 12 days(IQR: 8-19 days) for groups with UACR < 30 mg/g, 30-299 mg/g and ≥300 mg/g, respectively. Higher UACR conferred 72 to 85{\%} higher 90-, 180-, and 365-day mortality compared to UACR <30 mg/g (odds ratio and 95{\%} confidence interval for UACR ≥ 300 vs. <30 mg/g: 1.72(1.01-2.95); 1.85(1.14-3.01); 1.74(1.15-2.61), respectively). Higher UACR was also associated with significantly longer hospitalizations and higher incidence of all stages of AKI. Higher UACR is associated with significantly higher odds of mortality, longer post-CABG hospitalization, and higher AKI incidence.",
author = "Lekha George and Molnar, {Miklos Z.} and Lu, {Jun L.} and Kamyar Kalantar-Zadeh and Santhosh Koshy and Csaba Kovesdy",
year = "2015",
month = "11",
day = "9",
doi = "10.1038/srep16458",
language = "English (US)",
volume = "5",
journal = "Scientific Reports",
issn = "2045-2322",
publisher = "Nature Publishing Group",

}

TY - JOUR

T1 - Association of Pre-Operative Albuminuria with Post-Operative Outcomes after Coronary Artery Bypass Grafting

AU - George, Lekha

AU - Molnar, Miklos Z.

AU - Lu, Jun L.

AU - Kalantar-Zadeh, Kamyar

AU - Koshy, Santhosh

AU - Kovesdy, Csaba

PY - 2015/11/9

Y1 - 2015/11/9

N2 - The effect on post-operative outcomes after coronary artery bypass graft(CABG) surgery is not clear. Among 17,812 patients who underwent CABG during October 1,2006-September 28,2012 in any Department of US Veterans Affairs(VA) hospital, we identified 5,968 with available preoperative urine albumin-creatinine ratio(UACR) measurements. We examined the association of UACR<30, 30-299 and >=300 mg/g with 30/90/180/365-day and overall all-cause mortality, and hospitalization length >10 days, and with acute kidney injury(AKI). Mean ± SD baseline age and eGFR were 66 ± 8 years and 77 ± 19 ml/min/1.73 m2, respectively. 788 patients(13.2%) died during a median follow-up of 3.2 years, and 26.8% patients developed AKI(23.1%-Stage 1; 2.9%-Stage 2; 0.8%-Stage 3) within 30 days of CABG. The median lengths of stay were 8 days(IQR: 6-13 days), 10 days(IQR: 7-14 days) and 12 days(IQR: 8-19 days) for groups with UACR < 30 mg/g, 30-299 mg/g and ≥300 mg/g, respectively. Higher UACR conferred 72 to 85% higher 90-, 180-, and 365-day mortality compared to UACR <30 mg/g (odds ratio and 95% confidence interval for UACR ≥ 300 vs. <30 mg/g: 1.72(1.01-2.95); 1.85(1.14-3.01); 1.74(1.15-2.61), respectively). Higher UACR was also associated with significantly longer hospitalizations and higher incidence of all stages of AKI. Higher UACR is associated with significantly higher odds of mortality, longer post-CABG hospitalization, and higher AKI incidence.

AB - The effect on post-operative outcomes after coronary artery bypass graft(CABG) surgery is not clear. Among 17,812 patients who underwent CABG during October 1,2006-September 28,2012 in any Department of US Veterans Affairs(VA) hospital, we identified 5,968 with available preoperative urine albumin-creatinine ratio(UACR) measurements. We examined the association of UACR<30, 30-299 and >=300 mg/g with 30/90/180/365-day and overall all-cause mortality, and hospitalization length >10 days, and with acute kidney injury(AKI). Mean ± SD baseline age and eGFR were 66 ± 8 years and 77 ± 19 ml/min/1.73 m2, respectively. 788 patients(13.2%) died during a median follow-up of 3.2 years, and 26.8% patients developed AKI(23.1%-Stage 1; 2.9%-Stage 2; 0.8%-Stage 3) within 30 days of CABG. The median lengths of stay were 8 days(IQR: 6-13 days), 10 days(IQR: 7-14 days) and 12 days(IQR: 8-19 days) for groups with UACR < 30 mg/g, 30-299 mg/g and ≥300 mg/g, respectively. Higher UACR conferred 72 to 85% higher 90-, 180-, and 365-day mortality compared to UACR <30 mg/g (odds ratio and 95% confidence interval for UACR ≥ 300 vs. <30 mg/g: 1.72(1.01-2.95); 1.85(1.14-3.01); 1.74(1.15-2.61), respectively). Higher UACR was also associated with significantly longer hospitalizations and higher incidence of all stages of AKI. Higher UACR is associated with significantly higher odds of mortality, longer post-CABG hospitalization, and higher AKI incidence.

UR - http://www.scopus.com/inward/record.url?scp=84946924959&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84946924959&partnerID=8YFLogxK

U2 - 10.1038/srep16458

DO - 10.1038/srep16458

M3 - Article

C2 - 26548590

AN - SCOPUS:84946924959

VL - 5

JO - Scientific Reports

JF - Scientific Reports

SN - 2045-2322

M1 - 16458

ER -