Grant: Operating Grant

Approximately 40% of patients who undergo heart surgery will have a transient postoperative decrease in kidney function as measured by a serum creatinine blood test. The development of acute kidney injury (AKI) after heart surgery is strongly associated with prolonged hospitalization and an increased risk of death. While risk factors for AKI have been identified, accurate preoperative risk assessment remains difficult, due in part to an incomplete understanding of the factors responsible for AKI in this setting, and the uncertain prognostic significance of AKI in the long term (after hospital discharge). Previous research in this area has been hampered by by the limited availability of detailed clinicial and laboratory data with which to adequately evaluate risk. Early identification of patients at high risk for would be extremely valuable to physicians for preoperative patient counselling regarding the risk and benefits of surgery as well as a research tool for targeting preventative or therapeutic treatments for AKI to patients who may be most likely to benefit. The Alberta Provincial Program for Outcome Assessment in Coronary Heart Disease (APPROACH) and the Alberta Kidney Disease Network (AKDN) databases are unique resources that contain detailed demographic and medical information on patients who have undergone cardiac surgery. We propose to use these data sources to determine the relationship between the development of AKI after cardiac surgery and the short and long term risk of dialysis, death or rehospitalization. We will also evaluate existing risk assessment scores in these databases to determine if they accurately predict AKI and develop our own enhanced risk score using newly identified risk factors.