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논문분류	춘계학술대회 초록집
제목	Preoperative Low Urine pH predicts Acute Kidney Injury after Cardiac Surgery
저자	Min-uk CHA1, Misol LEE1, Ki heon NAM1, Seong yeong AN1, Jong hyun JHEE1, Seohyun PARK1, Hyoungnae KIM1, Hae-ryong YUN1, Youn kyung KEE1, Seung hyeok HAN1, Tae-hyun YOO1, Shin-wook KANG1,2, *Jung tak PARK1
출판정보	2017; 2017(1):
키워드	urine pH, acute kidney injury, cardiac surgery
초록	Objectives : Acute kidney injury (AKI) is a common complication after cardiac surgery. Previous studies have shown that renal function decline is aggravated in CKD patients with low urine pH. However, the relationship between urine pH and the development of AKI is not well investigated. In this study, the clinical implication of preoperative urine pH on AKI occurrence after cardiac surgery was evaluated. Methods : Patients who underwent coronary artery bypass graft or valve surgery at Yonsei University Health System from January 2013 to December 2014 were enrolled. Urinalysis and blood chemistry levels within 96 hours before cardiac surgery were adopted for preoperative values. The patients were divided into 3 groups based on preoperative urine pH levels, which represented group 1 <6.0; group 2 6.0 to 6.5; and group 3 >6.5. The primary outcome was the incidence of AKI within 48 hours after cardiac surgery. AKI was defined according to Acute Kidney Injury Network (AKIN) criteria. Results : A total of 832 patients were evaluated. The mean age was 60.1±14.7 years, and 492 patients (59.1%) were male. The mean preoperative urine pH level and eGFR were 5.8±0.8, and 84.0±23.4mL/min/1.73m2, respectively. AKI was observed in 208 patients (25.0%) after cardiac operation. The incidence of AKI was higher in group 1 (29.8%) than in group 2 (18.5%) and group 3 (17.4%) (P<0.001). Multivariate logistic regression showed that low preoperative urine pH was associated with AKI even after adjusting for age, sex, diabetes mellitus, preoperative hemoglobin, serum bicarbonate levels, and eGFR. Conclusions : Low preoperative urine pH is associated with higher incidence of AKI after cardiac surgery. Evaluating preoperative urine pH may help post cardiac surgery AKI prediction.
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