Gedevanishvili, Anna (2024) Application of the KDIGO criteria finds a ten-fold higher incidence of cardiac surgery-associated acute kidney injury compared to the NHR criteria. thesis, Medicine.
Full text available on request.Abstract
Background: Acute kidney injury (AKI), defined by a rapid increase in serum creatinine (SCr) and/or an abrupt decrease in urine output (UO), is a common complication after cardiac surgery (CS-AKI) and is strongly associated with short and long-term morbidity and mortality. The reported incidence of CS-AKI is highly variable, ranging from as low as 4% to as high as 94%, depending on the definition used for AKI, the type of surgical procedure, and the patient population studied. Currently, the Kidney Disease Improving Global Outcome (KDIGO) criteria are the gold standard for the assessment of AKI. In the Netherlands, the Dutch national quality registration (NHR) applies their own definition of AKI, which does not incorporate milder stages, leading to underdiagnosis and underreporting of AKI. This carries significant clinical ramifications, because even milder forms of AKI are associated with adverse long-term consequences. Methods: This study had a retrospective cohort design and included patients who underwent cardiac surgery in the University Medical Center of Groningen (UMCG) between 01-01-2022 and 31-12-2022. The primary outcome was the incidence of CS-AKI when applying the NHR and KDIGO criteria, respectively. Results: 714 patients were included for analysis. The NHR criteria found an AKI incidence of 4.2%. The incidence of AKI found through application of full KDIGO criteria was 46.1%. Applying KDIGO SCr criteria alone already provided more than a twofold increase in AKI incidence (10.5%) as compared to the NHR criteria. Conclusion: The KDIGO criteria are more sensitive in detecting postoperative AKI in CS patients than the NHR criteria.
| Item Type: | Thesis (UNSPECIFIED) |
|---|---|
| Supervisor name: | Koeze, J. and Nieuwenhuijs-Moeke, G.J. |
| Faculty: | Medical Sciences |
| Date Deposited: | 19 Sep 2025 11:11 |
| Last Modified: | 19 Sep 2025 11:11 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/3824 |
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