Derivation and Validation of a Simplified Predictive Index for Renal Replacement Therapy After Cardiac Surgery

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Abstract
Cardiac surgery remains a common surgical procedure, with approximately 646 000 open-heart operations performed annually in the United States alone.1 One of its most serious complications is acute renal failure. When severe enough to necessitate renal replacement therapy (RRT) with hemodialysis or continuous venovenous hemodiafiltration, postoperative acute renal failure is independently associated with mortality.2 Most clinicians believe that rates of RRT are likely to increase because patients undergoing cardiac surgery are increasingly older and have more comorbidity.3 Strategies that improve management of perioperative acute renal failure should, therefore, confer important benefits.