WASHINGTON — Lower hemoglobin levels may be a strong and independent predictor of higher risk of major adverse kidney events within 7 days after cardiac surgery or admittance to the ICU, according to data presented at ASN Kidney Week.
“Maintaining high hemoglobin before cardiac surgery at time of admission to the ICU could potentially decrease the risk of [acute kidney injury] AKI or death or need for renal replacement therapy,” Samuel Short, BA, of Brigham and Women's Hospital, told Healio Nephrology.
In the retrospective cohort study, Short and colleagues studied 18,784 patients who underwent cardiac surgery and 30,633 patients who were admitted to an ICU at two medical centers from 2005 to 2018. They excluded patients with ESRD or AKI. The primary endpoint of the study was a major adverse kidney event within 7 days after cardiac surgery or ICU admission, which was defined as an increase of serum creatinine greater than 100%, dialysis or death.
Overall, 6% of patients who had cardiac surgery and 14% of patients admitted to the ICU had a major adverse kidney event within 7 days. Both groups of patients with lower hemoglobin values had a monotonic increase for risk of a major adverse kidney event within 7 days. In a model adjusted for key cofounders, patients in the cardiac surgery group with hemoglobin less than 9 g/dL had a 7.3-fold higher risk of a major adverse kidney event within 7 days compared with patients who had hemoglobin levels from 12 g/dL to 15 g/dL. The researchers also found each 1-g/dL decrease in hemoglobin was associated with a 1.6-fold higher risk of a major adverse kidney event.
In a model adjusted key cofounders, patients in the ICU group who had hemoglobin less than 6 g/dL had a 2.3-fold increase of a major adverse kidney event within 7 days compared with patients with hemoglobin levels from 12 g/dL to 15 g/dL. – by Kristine Houck, MA, ELS
Short S, et al. Abstract TH-PO059. Presented at: ASN Kidney Week; Nov. 7-10, 2019; Washington D.C.
Disclosure: Short reports no relevant financial disclosures. The study received NIDDK support.