Abstract: Objectives To explore the risk factors for the cardiac surgery associated acute kidney injury (CSA-AKI) that needs renal replacement therapy (RRT) after cardiac surgery. Methods We retrospectively analyzed the clinical data of the patients with RRT after cardiac surgery treated in Nanjing First Hospital in the period from Jun. 2008 to Dec. 2012. Results A total of 2,810 consecutive patients who underwent cardiovascular surgery from 2008 to 2012 at the single institution were reviewed. Acute kidney injury was found in 982 (34.9%) patients, of which 33 patients (1.17%) required RRT and 25 patients died (0.089%) in hospital. Multivariate logistic regression showed that female (P=0.007, OR=0.323, 95% CI 0.142～0.734), lower BMI (P=0.053, OR=0.902, 95% CI 0.813～1.001), COPD history (P=0.005, OR=7.597, 95% CI 1.868～30.902), CKD history (P＜0.001, OR=7.782, 95% CI 2.551～23.735), lower left ventricular ejection fraction (P=0.019, OR=0.961, 95% CI=0.930～0.994), more red cell transfusion during operation (P＜0.001, OR=1.121, 95% CI 1.075~1.170) and postoperative fever over 38℃ (P=0.005, OR=3.345, 95% CI 1.449～7.723) were the risk factors for RRT after cardiac surgery. Receiver-operating characteristic curve analysis showed that the area under the curve was 0.8512. Conclusion The need for RRT after cardiac surgery was relatively high, and was closely related to several risk factors in the perioperative period.

Key words: Cardiac surgery, Acute kidney injury, Renal replacement therapy