Cem DOĞAN, Zübeyde BAYRAM, Rezan AKSOY, Taylan ADADEMİR, Rezzan Deniz ACAR, Kaan KIRALİ, NİHAL ÖZDEMİR, Tanıl ÖZER

Diabetes mellituslu hastalarda anjiyografi ve koroner arter baypas greftleme arasındaki zamanın ameliyat sonrası akut böbrek hasarı üzerine etkisi

Amaç: Bu çalışmada diabetes mellituslu hastalarda koroner anjiyografi ve koroner arter baypas greftleme arasında geçen zamanın ameliyat sonrası akut böbrek hasarı üzerindeki etkisi araştırıldı. Çalışma planı: Aralık 2013 - Kasım 2016 tarihleri arasında koroner arter baypas greftleme yapılan toplam 421 hasta (274 erkek, 147 kadın; ort. yaş 60±9.2 yıl; dağılım 31-84 yıl) çalışmaya alındı. Hastaların demografik özellikleri, eşlik eden hastalıkları, tıbbi ve cerrahi öyküleri, daha önce yapılan koroner anjiyografileri ve cerrahi ve laboratuvar sonuçları dahil olmak üzere veriler retrospektif olarak incelendi. Hastalar akut böbrek hasarı olanlar (n=108) ve akut böbrek hasarı olmayanlar (n=313) olmak üzere iki gruba ayrıldı. Akut böbrek hasarı, Risk, Hasar, Yetmezlik, Kayıp, Son Dönem Böbrek Hastalığı (RIFLE) kriterlerine göre tanımlandı. Ayrıca hastalar zaman aralığına göre üç alt gruba ayrıldı: 0-3 gün, 4-7 gün ve >7 gün. Bulgular: Koroner anjiyografi ve koroner arter baypass greftleme arasında geçen medyan süre açısından akut böbrek hasarı olan ve olmayan hastalar arasında istatistiksel olarak anlamlı bir fark yoktu (sırasıyla, 11.5 ve 12.0 gün; p=0.871). Akut böbrek hasarı risk faktörleri açısından alt gruplar arasında anlamlı bir fark yoktu. Çok değişkenli analizde geçirilmiş miyokard enfarktüsü (olasılık oranı [OR]: 5.192, %95 güven aralığı [GA]: 2.176-12.38; p

The effect of time between angiography and coronary artery bypass grafting on postoperative acute kidney injury in patients with diabetes mellitus

Background: This study aims to investigate the effect of timeinterval between coronary angiography and coronary artery bypassgrafting surgery on postoperative acute kidney injury in patientswith diabetes mellitus.Methods: Between December 2013 and November 2016, a total of421 diabetic patients (274 males, 147 females; mean age 60±9.2 years;range, 31 to 84 years) who underwent coronary artery bypass graftingwere included in the study. Data including demographic characteristicsof the patients, comorbidities, medical, and surgical histories, previouscoronary angiographies, and operative and laboratory results wereretrospectively analyzed. The patients were divided into two groups asthose with acute kidney injury (n=108) and those without acute kidneyinjury (n=313). The Risk, Injury, Failure, Loss, End-Stage KidneyDisease (RIFLE) criteria were used to define acute kidney injury. Thepatients were further classified into three subgroups according to thetime interval: 0-3 days, 4-7 days, and >7 days.Results: There was no statistically significant difference in themedian time between coronary angiography and coronary arterybypass grafting between the patients with and without acute kidneyinjury (11.5 and 12.0 days; respectively p=0.871). There was nosignificant difference in the risk factors for acute kidney injuryamong the subgroups. Multivariate analysis revealed that previousmyocardial infarction (odds ratio [OR]: 5.192, 95% confidenceinterval [CI]: 2.176-12.38; p

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