The Occurrence and Risk Factors of Acute Kidney Injury Among Patients Who Are Undergoing Cardiac Surgery in Palestine

Background: Acute kidney injury (AKI) is a sudden and long-lasting loss of kidney function that starts within seven days and causes a quick drop in the Glomerular Filtration Rate (GFR). A rise in serum creatinine and urine output depletion accompanies this. AKI occurs in 1% to 5% of all admissions, and 5% need dialysis, with cardiac surgery being the most common cause after sepsis. AKI increases infection risk, hospitalization length, costs, and mortality rate. This study aimed to measure the occurrence of AKI post cardiac surgery and the relationship between the risk factors and the dynamic predictive scoring system to the occurrence of AKI in cardiac surgery units. Methodology: This study adopted an observational prospective quantitative design and included 103 patients who underwent cardiac surgery between August 2020 and September 2021 in three cardiac surgery units in the West Bank in Palestine. The risk factors, serum creatinine, and demographic data were gathered preoperatively. AKI defined by the Kidney Disease Improving Global Outcome (KDIGO) criteria and the dynamic predictive scoring system used to estimate the risk of AKI after cardiac surgery. Statistical Package for the Social Sciences (SPSS version 25) program used for data entry and analysis. Results: Of the patients having cardiac surgery at three large hospitals in Palestine's West Bank, 27 (26.2%) had acute kidney injury (AKI), according to diagnostic criteria. AKI stage 1 (19.4%), 4.9% in stage 2, and 1.9% in stage 3. Statistically significant factors for AKI patients were oliguria time, vasopressor usage time > 24 hrs, and high serum creatinine on day 3. Regarding other variables, the results revealed no significant difference between patients with and without AKI (P>0.05). Conclusion: The AKI occurrence among patients undergoing cardiac surgery in the West Bank was high. The use of the vasopressor for more than 24 hours was significant in preventing AKI. Applying a predictive scoring system is crucial in predicting, preventing, and managing the problem. Integration of protocols, training workshops, and policies is important in the therapy regimen. We must conduct further experimental studies with a control group and a larger sample.
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