Evaluation of simplified renal index for renal replacement therapy after cardiac valve surgery

Jinqiang CHEN; Guanxin ZHANG; Chong WANG; Yang LIU; Lin HAN; Fanglin LU; Zhiyun XU

白话标题:SRI评分对于成人心脏瓣膜术后急性肾衰竭的预测价值
作者: Jinqiang CHEN ; Guanxin ZHANG ; Chong WANG ; Yang LIU ; Lin HAN ; Fanglin LU ; Zhiyun XU
关键字: Cardiac valve surgery; Acute kidney injury; Simplified renal index score; Validation
来源: Chinese Journal of Thoracic and Cardiovascular Surgery 2016;32(10):599-603
国家China
语言:Chinese
摘要: Objective To validate the value of Simplified Renal Index Score(SRI) in predicting acute renal injury requiring renal replacement therapy(RRT-AKI) after cardiac valve surgery in Chinese adult patients.Methods An analysis was conducted for all the adult patients who underwent cardiac valve surgery from January 2010 to December 2014 in Changhai Hospital,Shanghai.A total of 3 183 adult patients were included.Based on SRI Score,the patients were divided into 3 risk stages:0 to 1 point,2 to 3 point,and 4 to 8 point.The incidence of RRT-AKI was compared between different stages.And the prediction value of the SRI model was assessed by area under the receiver operating characteristic curve (AU-ROC) and the model calibration was assessed with the Hosmer-Lemeshow (H-L) test.Results After surgery 52 (1.6％) patients developed acute kidney impairment and subsequently underwent renal replacement therapy.Patients with low values of simplified renal index (0-1),medium(2-3) and high values (4 and more) were found to have increasingly higher risk for renal replacement therapy of 0.8％ (95％ CI:0.005-0.012) 、3.8％ (95％ CI:0.026-0.052) 、20％ (95％ CI:0.010-0.720),respectively.TheAU-ROCwas0.68(95％ CI:0.610-0.760,P＜0.01).The H-L test was x2 =2.45,P=0.29.Conclusion SRI model gives a certain clinical significance,suggesting that high-values patients may occur RRT-AKI with a significantly higher risk than low-values patients.However,SRI model cannot give an accurate prediction value for RRT-AKI in Chinese adult patients after cardiac valve surgery.Direct clinical use of the model should be considered cautiously.