Clinical Case 68 : Answers and Summary

67 Y OLD MALE POST CABG -NOTED TO HAVE A SERUM CREATININE OF 1.4MG/DL. HIS SERUM CREATININE PRE-OP WAS 1.0MG/DL. HIS RENAL FUNCTION RESOLVES TO BASELINE AFTER 2 DAYS. HIS MORTALITY IS....

The three surgical procedures with highest renal injury risk are: cardiac surgery, AAA and post obstructive jaundice gall bladder operation. Incidence of AKI ranges from 1-30% in patients with cardiac surgery and typical CABG is around 2.5%, valvular surgery 2.8% and both combined is 4.6% and risk increases in each category with AKI with need for dialysis. One study showed that even a small minute change in serum creatinine during the post op period after cardiac surgery, increased the mortality significantly.