Evaluation of simplified renal index for renal replacement therapy after cardiac valve surgery
10.3760/cma.j.issn.1001-4497.2016.10.005
- VernacularTitle:SRI评分对于成人心脏瓣膜术后急性肾衰竭的预测价值
- Author:
Jinqiang CHEN
;
Guanxin ZHANG
;
Chong WANG
;
Yang LIU
;
Lin HAN
;
Fanglin LU
;
Zhiyun XU
- Keywords:
Cardiac valve surgery;
Acute kidney injury;
Simplified renal index score;
Validation
- From:
Chinese Journal of Thoracic and Cardiovascular Surgery
2016;32(10):599-603
- CountryChina
- Language:Chinese
-
Abstract:
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.
