Acute Kidney Injury After Cardiac Surgery: Novel Ultrasound Techniques for Prediction of Acute Kidney Injury

Aarhus University Hospital

Status: Completed

Conditions: Cardiac Surgery; Acute Kidney Injury; Acute Renal Failure

Treatments: Procedure: On-pump cardiac surgery

Study type: Observational

Funder types: Other

Identifiers

NCT03727204

1-10-72-267-18

Details and patient eligibility

About

Acute Kidney Injury (AKI) is a frequent and important complication to cardiac surgery. This study will evaluate the diagnostic ability of ultrasonographic measures of blood flow in kidneys and liver in predicting AKI after cardiac surgery.

Full description

Acute Kidney Injury (AKI) is a frequent and important complication to cardiac surgery. The pathophysiology is multifactorial, but renal functions in this setting is determined by a complex interplay between renal perfusion, fluid status, cardiac output, mean arterial pressure and back pressure to venous outflow.

Renal perfusion may be quantified with novel ultrasound techniques. Ultrasonography of the kidney and renal vasculature allows for assessment of renal afferent flow and renal venous flow and, together with venous flow patterns of the portal vein and liver veins, may identify patients in risk of AKI.

The study is observational and will describe the diagnostic accuracy of the ultrasound measures in predicting postoperative AKI. Patients will be examined with ultrasound of kidney and liver flow along with echocardiography on on the day before surgery and on the 1st and 4th. In addition, patients are followed with markers of kidney function, fluid balance and invasive measures of mean arterial pressure and central venous pressure.

Enrollment: 150 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• All patients ≥ 18 years
• Scheduled for on-pump cardiac surgery
• Oral and written consent

AND

• 1 of the following risk factors for development of postoperative AKI may be included:

  • age > 70 years;

  • NYHA (New York Heart Association) 3+4;

  • Insulin dependent diabetes;

  • Glomerular filtration rate < 60 ml/min/1,73 m2;

  • Ejection fraction < 35;

  • Surgery:

    • Combined CABG and valve surgery;
    • Any valve surgery except isolated aortic-valve surgery;
    • Redo surgery;
    • Endocarditis;

  • Peripheral vascular disease.

Exclusion criteria

• Insufficient ultrasonographic imaging of the kidneys;
• Known morphological kidney disease;
• Preoperative dialysis;
• Prior participation in the study.

Trial design

150 participants in 2 patient groups

Aarhus University Hospital

Description:

100 patients undergoing on-pump cardiac surgery at Charlotte Maxeke Johannesburg Academic Hospital, University of the Witwatersrand

Treatment:

Procedure: On-pump cardiac surgery

Charlotte Maxeke Johannesburg Academic Hospital, University of the Witwatersrand

Description:

50 patients undergpoing on-pump cardiac surgery at at Charlotte Maxeke Johannesburg Academic Hospital, University of the Witwatersrand

Treatment:

Procedure: On-pump cardiac surgery