EFFECT OF PHASE ANGLE BY ELECTRICAL BIOIMPEDANCE ON THE INCIDENCE AND SEVERITY OF ACUTE KIDNEY INJURY FOLLOWING CARDIAC SURGERY

E-Poster

https://storage.unitedwebnetwork.com/files/1099/b1912319f7722b40e3ca91221b798ae7.pdf

Abstract Title

First Name *

Hugo Leonardo

Last Name *

Reynoso de la Torre

Co-author 1

Jorge Andrade Sierra jorg_andrade@hotmail.com Instituto Mexicano del Seguro Social Department of Nephrology and Organ Transplant Unit, Specialties Hospital, National Western Medical Centre Guadalajara

Co-author 2

Mauricio Carvallo Venegas carvallomauricio@hotmail.com Instituto Mexicano del Seguro Social Department of Nephrology and Organ Transplant Unit, Specialties Hospital, National Western Medical Centre Guadalajara, Jalisco

Co-author 3

Co-author 4

Co-author 5

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Co-author 7

Co-author 8

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Introduction

Bioimpedance (BE) measures the electrical characteristics of the body to evaluate the patient's fluid, nutritional, and pathological condition by measuring resistance, reactance, and phase angle (PA). Low preoperative PA is related to greater morbidity and mortality, although the exact relationship with the development of acute kidney injury (AKI) is unclear. Objective: This research aimed to determine whether or not preoperative PA increased the risk for AKI following cardiac surgery.

Methods

Prospective Cohort from August-2022 to October-2023 that included 120 patients ≥18 years old, undergoing elective valve replacement or coronary bypass surgery, or both, in a single surgical procedure. PA was measured (BCM- edition 9/01.13 version 3.3x) 24 hours before surgery and standardized PA was calculated using data from the Mexican population. Serum creatinine (SCr) was assessed, and the occurrence and severity of AKI were confirmed 7 days following surgery.

Results

The mortality rate in the first seven days following surgery was 13% (16 patients) and the incidence of AKI was 37% (44 patients); 26% (31 patients) experienced mild AKI, whereas 11% (13 patients) developed moderate-severe AKI. A PA ≤4.5 was related to older age(p=0.014), less body weight (p=0.000), and less grip strength (p=0.001), but it was not associated with postoperative AKI and mortality. A standardized PA >-0.54 was related to a lower incidence of mild AKI, 8% (2/24 patients) vs 30% (29/95 patients) (p=0.029), with a relative risk of 0.26 (95% confidence interval, 0.07-1.05), with no difference in the incidence of moderate-severe AKI and mortality. In a logistic regression analysis, risks factors for AKI were glomerular filtration rate (GFR)(p=0.001), standardized PA (p=0.029), and weight (p=0.062).

Multivariable regression analysis for AKI
X2= 22.995, gl 3, p=0.000
Variable	Risk	CI 95%	p value
GFR (ml/min/1.73m2)	0.961	0.939-0.984	0.001
sPA>-0.54	0.254	0.074-0.870	0.029
Weight (kg)	1.032	0.998-1.066	0.062

Conclusions

Preoperative PA ≤ 4.5° did not increase the risk of AKI and mortality 7 days after cardiac surgery, while a standardized PA >-0.54 could be protective for AKI.

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