Analysis Of Related Factors Of Postoperative Acute Kidney Injury In Patients With Rheumatic Heart Disease

Objective: Rheumatic heart disease(RHD)is one of the most common heart diseases in China.Surgical treatment is the most effective way of RHD.To understand the incidence of acute renal injury(AKI)and related risk factors in patients with RHD,thereby reducing the incidence of AKI after rheumatic valvular heart disease surgery,and provide a theoretical basis for providing effective interventions and improving the prognosis of AKI.Methods: A retrospective analysis method was used to collect 147 patients with RHD undergoing valve replacement from October 2016 to December 2018 in the Department of Cardiothoracic Surgery,Affiliated Hospital of North Sichuan Medical College.Collect demographic characteristics,clinical basic data,complications,and prognosis.Logistic multivariate regression model was used to analyze the risk factors for postoperative AKI in patients with RHD.Results:(1)Among 147 patients with rheumatic heart disease,40 were males,107 were females,19 were hypertension,22 were diabetes,66 were AKI after 147 cardiac operations,81 were AKI-free,the incidence was 44.9%.(2)Univariate analysis of AKI risk after cardiac valve replacement showed age,height,preoperative creatinine,preoperative HB,preoperative urea nitrogen,preoperative eGFR,preoperative albumin,left ventricular ejection fraction,cardiopulmonary bypass time,aortic blocking time,MAP,intraoperative red blood cell volume,intraoperative plasma volume,contrast agent used within 7 days before surgery,diabetes,hypertension,atrial fibrillation,cardiac function grading,replacement valve type,pulmonary infection statistics academic significance.BMI,gender,and weight were not statistically significant.(3)Logistic multivariate regression analysis showed that height BMI(P=0.034),preoperative creatinine(P=0.001),,intraoperative plasma transfusion(P=0.017)had statistical significance.Conclusions:(1)Age,hypertension,hypoproteinemia,and pulmonary infection are risk factors for postoperative AKI in patients with rheumatic heart disease.(2)Preoperative creatinine,BMI,and intraoperative plasma volume are independent risk factors for postoperative AKI in patients with rheumatic heart disease.