J Bras Nefrol. 2026 Jan-Mar;48(1):e20250135. doi: 10.1590/2175-8239-JBN-2025-0135en.
ABSTRACT
INTRODUCTION: Acute kidney injury (AKI) is a common complication in the postoperative period of heart transplantation and is associated with unfavorable patient outcomes.
OBJECTIVE: To analyze the incidence of AKI in patients undergoing heart transplantation and to identify preoperative, intraoperative, and postoperative risk factors associated with its development.
METHODS: This was a single-center retrospective cohort study including patients who underwent heart transplantation during the first three years of the program at a tertiary hospital in the State of São Paulo, from January 2020 to January 2023. Patients with chronic kidney disease (CKD) stages 4 or 5 and prior kidney transplantation were excluded.
RESULTS: The incidence of AKI was 48%. Logistic regression analysis demonstrated an association between AKI and the following factors: pre-existing CKD (OR = 3.155; 95% CI 1.343-6.340; p = 0.031), cold ischemia time (OR = 1.956; 95% CI 1.126-3.053; p = 0.042), and higher doses of norepinephrine in the first postoperative day (OR = 5.211; 95% CI 2.696-8.987; p = 0.028). There was no significant difference in mortality between patients who developed AKI and those who did not (58.3% vs. 38.5%; p = 0.09).
CONCLUSION: The incidence of AKI was high (48%) in this population. The main risk factors for its development were pre-existing CKD, prolonged cold ischemia time, and higher doses of norepinephrine in the first postoperative day.
PMID:41801241 | DOI:10.1590/2175-8239-JBN-2025-0135en