open access

Vol 27, No 4 (2020)
Original articles — Clinical cardiology
Published online: 2019-02-20
Get Citation

Anisocytosis predicts postoperative renal replacement therapy in patients undergoing heart valve surgery

Piotr Duchnowski, Tomasz Hryniewiecki, Mariusz Kuśmierczyk, Piotr Szymański
DOI: 10.5603/CJ.a2019.0020
·
Pubmed: 30799549
·
Cardiol J 2020;27(4):362-367.

open access

Vol 27, No 4 (2020)
Original articles — Clinical cardiology
Published online: 2019-02-20

Abstract

Background: Acute kidney injury (AKI) is one of the serious postoperative complications in patients undergoing heart valve surgery. The aim of the present study was to identify selected biomarkers to predict AKI requiring renal replacement.
Methods: A prospective study was conducted on a group of 751 patients undergoing heart valve surgery. The data on risk factors, preoperative complete blood count, course of operations and postoperative period was assessed. The primary endpoint at the 30-day follow-up was postoperative AKI requiring renal replacement therapy. The secondary end-point was death from all causes in patients with postoperative AKI requiring renal replacement.
Results: The primary endpoint occurred in 46 patients. At multivariate analysis: age, red cell distribution width (RDW) and C-reactive protein remained independent predictors of the primary endpoint. Hemoglobin and RDW were associated with an increased risk of death.
Conclusions: Elevated RDW is associated with a higher risk of postoperative AKI and death in patients with AKI.

Abstract

Background: Acute kidney injury (AKI) is one of the serious postoperative complications in patients undergoing heart valve surgery. The aim of the present study was to identify selected biomarkers to predict AKI requiring renal replacement.
Methods: A prospective study was conducted on a group of 751 patients undergoing heart valve surgery. The data on risk factors, preoperative complete blood count, course of operations and postoperative period was assessed. The primary endpoint at the 30-day follow-up was postoperative AKI requiring renal replacement therapy. The secondary end-point was death from all causes in patients with postoperative AKI requiring renal replacement.
Results: The primary endpoint occurred in 46 patients. At multivariate analysis: age, red cell distribution width (RDW) and C-reactive protein remained independent predictors of the primary endpoint. Hemoglobin and RDW were associated with an increased risk of death.
Conclusions: Elevated RDW is associated with a higher risk of postoperative AKI and death in patients with AKI.

Get Citation

Keywords

anisocytosis, red cell distribution width, valve surgery, acute kidney injury

About this article
Title

Anisocytosis predicts postoperative renal replacement therapy in patients undergoing heart valve surgery

Journal

Cardiology Journal

Issue

Vol 27, No 4 (2020)

Pages

362-367

Published online

2019-02-20

DOI

10.5603/CJ.a2019.0020

Pubmed

30799549

Bibliographic record

Cardiol J 2020;27(4):362-367.

Keywords

anisocytosis
red cell distribution width
valve surgery
acute kidney injury

Authors

Piotr Duchnowski
Tomasz Hryniewiecki
Mariusz Kuśmierczyk
Piotr Szymański

References (31)
  1. Knight JB, Lebovitz EE, Gelzinis TA, et al. Preoperative risk factors for unexpected postoperative intensive care unit admission: A retrospective case analysis. Anaesth Crit Care Pain Med. 2018; 37(6): 571–575.
  2. Tóth R, Breuer T, Cserép Z, et al. Acute kidney injury is associated with higher morbidity and resource utilization in pediatric patients undergoing heart surgery. Ann Thorac Surg. 2012; 93(6): 1984–1990.
  3. Lopez-Delgado JC, Esteve F, Torrado H, et al. Influence of acute kidney injury on short- and long-term outcomes in patients undergoing cardiac surgery: risk factors and prognostic value of a modified RIFLE classification. Crit Care. 2013; 17(6): R293.
  4. Liu Y, Zhang H, Liu Y, et al. Risk factors and short-term prognosis of preoperative renal insufficiency in infective endocarditis. J Thorac Dis. 2018; 10(6): 3679–3688.
  5. Dhoble A, Zhao Y, Vejpongsa P, et al. National 10-year trends and outcomes of isolated and concomitant tricuspid valve surgery. J Cardiovasc Surg (Torino). 2019; 60(1): 119–127.
  6. Lei C, Berra L, Rezoagli E, et al. Nitric oxide decreases acute kidney injury and stage 3 chronic kidney disease after cardiac surgery. Am J Respir Crit Care Med. 2018; 198(10): 1279–1287.
  7. Amini S, Abbaspour H, Morovatdar N, et al. Risk factors and outcome of acute kidney injury after congenital heart surgery: a prospective observational study. Indian J Crit Care Med. 2017; 21(12): 847–851.
  8. Feng C, Naik BI, Xin W, et al. Haptoglobin 2-2 phenotype is associated with increased acute kidney injury after elective cardiac surgery in patients with diabetes mellitus. J Am Heart Assoc. 2017; 6(10).
  9. Olivero JJ, Olivero JJ, Nguyen PT, et al. Acute kidney injury after cardiovascular surgery: an overview. Methodist Debakey Cardiovasc J. 2012; 8(3): 31–36.
  10. Romagnoli S, Ricci Z, Ronco C. Perioperative acute kidney injury: prevention, early recognition, and supportive measures. Nephron. 2018; 140(2): 105–110.
  11. Ronco C. Hemodiafiltration: technical and clinical issues. Blood Purification. 2015; 40(1): 2–11.
  12. den Hoedt CH, Bots ML, Grooteman MPC, et al. CONTRAST Investigators. Online hemodiafiltration reduces systemic inflammation compared to low-flux hemodialysis. Kidney Int. 2014; 86(2): 423–432.
  13. Eremenko AA, Pavlov MV, Kolpakov PE, et al. [The influence of continuous veno-venous haemodiafiltration start time on multiple organ dysfunction syndrome treatment results in cardiac surgery patients]. Anesteziol Reanimatol. 2013(2): 63–66.
  14. Duchnowski P, Hryniewiecki T, Stokłosa P, et al. Number of erythrocytes as a prognostic marker in patients undergoing heart valve surgery. Kardiol Pol. 2018; 76(4): 791–793.
  15. Aslan D, Gümrük F, Gürgey A, et al. Importance of RDW value in differential diagnosis of hypochrome anemias. Am J Hematol. 2002; 69(1): 31–33.
  16. Montagnana M, Cervellin G, Meschi T, et al. The role of red blood cell distribution width in cardiovascular and thrombotic disorders. Clin Chem Lab Med. 2011; 50: 635–41.
  17. Duchnowski P, Hryniewiecki T, Kusmierczyk M, et al. Red cell distribution width is a prognostic marker of perioperative stroke in patients undergoing cardiac valve surgery. Interact Cardiovasc Thorac Surg. 2017; 25(6): 925–929.
  18. Montagnana M, Cervellin G, Meschi T, et al. The role of red blood cell distribution width in cardiovascular and thrombotic disorders. Clin Chem Lab Med. 2011; 50: 635–641.
  19. Salvagno GL, Sanchis-Gomar F, Picanza A, et al. Red blood cell distribution width: A simple parameter with multiple clinical applications. Crit Rev Clin Lab Sci. 2015; 52(2): 86–105.
  20. Duchnowski P, Hryniewiecki T, Stokłosa P, et al. Red Cell Distribution Width as a Prognostic Marker in Patients Undergoing Valve Surgery. J Heart Valve Dis. 2017; 26: 714–720.
  21. Tonelli M, Sacks F, Arnold M, et al. Relation between red blood cell distribution width and cardiovascular event rate in people with coronary disease. Circulation. 2008; 117: 163–168.
  22. Duchnowski P, Hryniewiecki T, Kuśmierczyk M, et al. The usefulness of selected biomarkers in aortic regurgitation. Cardiol J. 2018 [Epub ahead of print].
  23. Balta S, Demirkol S, Aydogan M, et al. Red cell distribution width is a predictor of mortality in patients undergoing coronary artery bypass surgery. Eur J Cardiothorac Surg. 2013; 44(2): 396–397.
  24. Duchnowski P, Hryniewiecki T, Kuśmierczyk M, et al. Red cell distribution width as a predictor of multiple organ dysfunction syndrome in patients undergoing heart valve surgery. Biol Open. 2018; 7(10).
  25. Magri CJ, Chieffo A, Latib A, et al. Red blood cell distribution width predicts one-year mortality following transcatheter aortic valve implantation. Int J Cardiol. 2014; 172(2): 456–457.
  26. Aung N, Dworakowski R, Byrne J, et al. Progressive rise in red cell distribution width is associated with poor outcome after transcatheter aortic valve implantation. Heart. 2013; 99: 1261–1266.
  27. Duchnowski P, Hryniewiecki T, Koźma M, et al. High-sensitivity troponin T is a prognostic marker of hemodynamic instability in patients undergoing valve surgery. Biomark Med. 2018; 12(12): 1303–1309.
  28. Zou Z, Zhuang Y, Liu L, et al. Role of elevated red cell distribution width on acute kidney injury patients after cardiac surgery. BMC Cardiovasc Disord. 2018; 18: 166.
  29. Vashistha T, Streja E, Molnar MZ, et al. Red cell distribution width and mortality in hemodialysis patients. Am J Kidney Dis. 2016; 68(1): 110–121.
  30. Patel KV, Mohanty JG, Kanapuru B, et al. Association of the red cell distribution width with red blood cell deformability. Adv Exp Med Biol. 2013; 765: 211–216.
  31. Friedman JS, Lopez MF, Fleming MD, et al. SOD2-deficiency anemia: protein oxidation and altered protein expression reveal targets of damage, stress response, and antioxidant responsiveness. Blood. 2004; 104(8): 2565–2573.

Important: This website uses cookies. More >>

The cookies allow us to identify your computer and find out details about your last visit. They remembering whether you've visited the site before, so that you remain logged in - or to help us work out how many new website visitors we get each month. Most internet browsers accept cookies automatically, but you can change the settings of your browser to erase cookies or prevent automatic acceptance if you prefer.

By "Via Medica sp. z o.o." sp.k., ul. Świętokrzyska 73, 80–180 Gdańsk, Poland
tel.:+48 58 320 94 94, fax:+48 58 320 94 60, e-mail: viamedica@viamedica.pl