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Association between blood transfusion and serum creatinine as a major risk factor in patients undergoing cardiac surgeries: An observational study

Anita Teli, Ravi Ghatnatti.


Abstract

Background: Blood transfusion is associated with altered serum creatinine levels. However, there are not many studies available to substantiate the cause of acute kidney injury (AKI) in patients undergoing cardiac surgeries.

Aims and Objectives: The present study was aimed to assess and analyze serum creatinine levels, after blood transfusion (post-operative) in patients undergoing cardiac surgery and to assess its significance as a potential diagnostic and prognostic serum biomarker in predicting renal dysfunction.

Materials and Methods: An observational study was performed after obtaining the Institution’s Ethical Committee approval. Patients (n = 162) who underwent cardiac surgeries were considered for the study and were evaluated for alterations in serum creatinine levels and creatinine clearance rate, before (pre-operative) and after blood transfusion (post-operative). Analysis of variance, paired t-test, Chi-square test, and logistic regression test were used.

Results: Statistically significant difference (P < 0.0001) in mean creatinine levels as well as creatinine clearance rate was observed in 70 patients who were at a greater risk of developing AKI (post-operative). Post-operative median creatinine level as well as creatinine clearance rate were also significantly different (P < 0.001) in AKI group, compared to non-AKI group. Mean difference between pre- and post-operative serum creatinine, for congenital procedure, was statistically significant (P < 0.001).

Conclusion: Blood transfusion is often associated with altered serum creatinine levels, leading to unfortunate adverse effects of potentially renal dysfunction. Therefore, better blood conservation and anesthetic techniques should be studied upon to prevent excessive bleeding and avoid unnecessary blood transfusion.

Key words: Blood Transfusion; Creatinine; Acute Kidney Injury; Cardiovascular Risk; Blood Conservation; Anesthetic Techniques






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