АКШ

					disease on		return to operating	and 0.30±0.33 mg/L,
					immunosuppres		room, prevalence	respectively; p=0.40).
					sion, chronic		of postoperative
					moderate to		atrial fibrillation,
					high-dose		and the duration of
					corticosteroid		stay in the ICU
					therapy, ESRD,		and hospital
					patients
					receiving IV
					nitrates.
The role of	To	Systemat	974	RCTs that compared	The following	ARF requiring	Peak postsurgery	A pooled estimate	p=0.002	OR: 0.32;	A pooled estimate showed that
natriuretic	systematically	ic review		any form or dose of	studies were	dialysis, 30-d or	serum creatinine	showed that the use of	for AKI	95% CI:	natriuretic peptide administration
peptide	review these	and		natriuretic peptide	excluded: (1)	in-hospital	levels, postsurgery	natriuretic peptide	requiring	0.15 to	was not associated with a
administrati	trials to	meta-		with placebo in adult	nonrandomized	mortality	urine output,	was associated with a	dialysis	0.66 for	statistically significant reduction
on in CV	ascertain the	analysis		(age >18 y) patients	trials, (2)		postsurgery serum	reduction in ARF		AKI	in mortality (OR: 0.59; 95% CI:
surgery-	role of			undergoing CV	duplicate		aldosterone levels,	requiring dialysis		requiring	0.31 to 1.12; p=0.53).
associated	natriuretic			surgeries, and that	publications,		duration of	(OR: 0.32; 95% CI:		dialysis
renal	peptide			reported at least 1 of	(3) those		mechanical	0.15 to 0.66;
dysfunction:	administration			the following	evaluating the		ventilation, and	p=0.002). Other
a systematic	in the			prespecified renal	role of		length of ICU	benefits were a
review and	management			outcomes: ARF	natriuretic		stay.	reduction in
meta-	of CV surgery-			requiring dialysis,	peptides in a			postsurgery peak
analysis of	associated			peak postsurgery	noncardiovascu			serum creatinine
RCTs. 2009	renal			serum creatinine	lar surgical			levels (WMD/OR:
(257)	dysfunction.			levels, or	setting (i.e.,			−0.27; 95% CI: −0.38
				postsurgery urine	major			to −0.16; p<0.002), an
				output.	abdominal			increase in
					surgery and			postsurgery urine
					radiocontrast			output (WMD/OR:
					nephropathy			600; 95% CI: 330 to
					prevention), (4)			870; p<0.001), a
					experimental			reduction in
					animal studies,			postsurgery serum
					and (5) those			aldosterone levels,
					that did not			and reductions in
					report the			mechanical
					prespecified			ventilation duration
					renal outcomes			and ICU stay length.
					(including
					those in which
					information on
					renal outcomes
© American College of Cardiology Foundation and American Heart Association, Inc.

					was not
					available
					despite
					contacting the
					original study
					authors).
Beneficial	To determine	Systemat	1,290	The following	Exclusion	The number of	The incidence of	Fenoldopam use	p=0.007	OR: 0.54;	N/A
impact of	the impact of	ic review		inclusion criteria	criteria were:	patients	AKI and	decreased the risk of	(for AKI	95% CI:
fenoldopam	fenoldopam on	and		were used for	(1) studies	progressing to	hypotension, peak	RRT (6.5% in the	requiring	0.34 to
in critically	AKI, patient	meta-		potentially relevant	selecting only	AKI that requires	serum creatinine	fenoldopam group vs.	RRT);	0.84 (for
ill patients	mortality, and	analysis		studies: (1) random	patients	at least 1 episode	levels, long-term	10.4% in the control	p=0.01 (for	AKI
with or at	length of			allocation to	undergoing	of RRT, the	survival, and the	arm; OR: 0.54; 95%	mortality);	requiring
risk for	hospital stay in			treatment, (2)	procedures	incidence of in-	duration of ICU	CI: 0.34 to 0.84;	p<0.001(fo	RRT);
ARF: a	critically ill			comparison of	with	hospital	and hospital stays	p=0.007) and of all-	r AKI).	OR: 0.64;
meta-	patients			fenoldopam vs.	angiographic	mortality		cause mortality		95% CI:
analysis of				control treatment,	contrast media,			(15.1% vs. 18.9%;		0.45 to
randomized				and (3) performed in	(2) nonparallel			OR: 0.64; 95% CI:		0.91
clinical				surgical or intensive	design (i.e.,			0.45 to 0.91; p=0.01),		(mortality)
trials. 2007				care patients (thus	crossover)			as well as AKI		, OR: 0.43;
(258)				not including	randomized			(16.0% vs. 28.3%;		95% CI:
				patients administered	trials, (3)			OR: 0.43; 95% CI:		0.32 to
				radiocontrast dye).	duplicate			0.32 to 0.59;		0.59
					publications (in			p<0.001).		(AKI).
					this case, only
					the article
					reporting the
					longest follow-
					up was
					abstracted), (4)
					nonhuman
					experimental
					studies, and (5)
					no outcome
					data.
Fenoldopam	To study	RCT	155	ICU patients with a	Exclusion	The incidence of	N/A	Overall in critically ill	p=0.049	N/A	There was no statistically
mesylate in	whether			serum creatinine	criteria were a	dialysis therapy		patients, 27.5% in the	for the		significant difference in 21-d
early acute	administration			level increasing to	clinical	and/or all-cause		fenoldopam group	incidence		mortality rates between the 2
tubular	of low-dose			50%> a normal	diagnosis of	mortality at 21 d.		developed ATN	of ATN in		groups. However, fenoldopam
necrosis: a	fenoldopam			baseline level	ARF from			compared with 38.7%	cardiac		reduced the incidence of ATN in
randomized,	during early			(creatinine >1.5	causes other			in the placebo group	surgery		postoperative cardiothoracic
double-	ATN would			mg/dL [>133	than ATN,			(p=0.235). Similarly,	patients		surgery patients with early ATN
blind,	decrease the			μmol/L]) or a 25%	ARF after renal			there was no			(17.6% vs. 38.8%; p=0.049).

© American College of Cardiology Foundation and American Heart Association, Inc.

placebo-	need for			increase > a baseline	transplantation,			difference in the
controlled	dialysis			level >1.5 mg/dL	and pregnancy			incidence of dialysis
clinical trial.	therapy and/or			(>133 μmol/L)				therapy between
2005 (259)	incidence of			during a single 24-h				patients randomly
	death at 21 d.			period were				assigned to
				considered to have a				fenoldopam.
				diagnosis of ATN.
				Patients with ATN
				and MAP >70 mm
				Hg with adequate
				central venous
				pressure and
				administered no
				more than 2
				vasopressors were
				eligible for study
				enrollment.
Fenoldopam	To evaluate	RCT	193	Patients were	Exclusion	AKI	Need for RRT	AKI developed in	p=0.02	N/A
infusion for	the			included if at least 1	criteria were			12.6% patients	(ATN rate),
renal	renoprotective			of the following risk	defined by age			receiving fenoldopam	p=0.004
protection in	effects of			factors was present:	<18 y,			and in 27.6% patients	(need for
high-risk	fenoldopam in			preoperative serum	preoperative			receiving placebo	RRT)
cardiac	patients at high			creatinine >1.5	use of			(p=0.02), whereas
surgery	risk of			mg/dL, age >70 y,	inotropes,			renal replacement
patients: a	postoperative			diabetes mellitus on	preoperative			therapy was not
randomized	AKI			insulin treatment, or	dialysis, and			required in
clinical	undergoing			prior cardiac surgery	known allergy			fenodolpam group,
study. 2007	elective				to fenoldopam			but it was started in
(260)	cardiac				mesylate.			8.2% patients in
	surgery							placebo group
	requiring CPB.							(p=0.004). Serum
								creatinine was similar
								at baseline (1.8±0.4
								mg/dL vs. 1.9±0.3
								mg/dL) in the
								fenoldopam and
								placebo groups but
								differed significantly
								(p<0.001 and
								p<0.001) 24 h
								(1.6±0.2 mg/dL vs.
								2.5±0.6 mg/dL) and			N/A

© American College of Cardiology Foundation and American Heart Association, Inc.

								48 h (1.5±0.3 mg/dL
								vs. 2.8±0.4 mg/dL)
								after the operation.
Effects of	To determine	RCT	80	Patients scheduled	Exclusion	The adequacy of	Renal function	There was a	p=0.045	N/A
fenoldopam	the effects of			for elective cardiac	criteria:	perfusion	during and after	significantly higher	for the rate
infusion in	fenoldopam in			operations on CBP,	absence of		CPB (incidence of	rate of AKI in the	of AKI
complex	a population of			over 18 y, and who	written consent		AKI, changes in	placebo group (10%
cardiac	patients			had planned	and allergy to		urine output,	vs. 0%; p=0.045).
surgical	undergoing			complex cardiac	femoldopam.		changes in serum	Urine output during
operations: a	complex			operation (coronary			creatinin), in-	and after CPB did not			Patients in the fenoldopam group
prospective,	cardiac			and valve operation,			hospital mortality,	differ between			had higher oxygen delivery
randomized,	operations.			double/triple valve			major morbidity	groups, nor did the			during CPB and a significantly
double-				operation, ascending				renal function			lower perfusion pressure,
blind,				aorta operation)				parameters.			although this parameter was still
placebo-				requiring a							within the normal range. Blood
controlled				predictable CPB							lactate concentrations during
study. 2010				time of >90 min							CPB were similar in the 2
(261)				were included							groups.
Fenoldopam	To determine	Meta-	1,059	The following	The exclusion	The number of	Peak serum	Pooled estimates	p<0.001	OR: 0.37;	N/A
reduces the	the efficacy of	analysis		inclusion criteria	criteria were	patients	creatinine levels,	showed that	(need for	95% CI:
need for	fenoldopam in			were used for	(1) nonparallel	requiring at least	and the duration of	fenoldopam	RRT);	0.23 to
renal	the prevention			potentially relevant	design (i.e.,	1 episode of	mechanical	consistently and	p<0.01	0.59 (need
replacement	of ARF, the			studies: (1) clinical	crossover)	RRT, the	ventilation, ICU	significantly reduced	(mortality)	for RRT),
therapy and	authors			trial comparing	randomized	incidence of in-	and hospital stay,	the need for renal		OR: 0.46:
in-hospital	performed a			fenoldopam with	trials, (2)	hospital	hypotension, or	replacement therapy		95% CI:
death in CV	systematic			control treatment, (2)	duplicate	mortality	the use of	(5.7% vs.13.4%; OR:		0.29 to
surgery: a	review of			clinical trial using	publications (in		vasoconstrictors.	0.37; 95% CI: 0.23 to		0.75 (for
meta-	RCTs and			random allocation or	this case only			0.59; p<0.001 and in-		mortality)
analysis.	propensity-			adjustment for	the article			hospital death (OR:
2008 (262)	matched			covariates (for	reporting the			0.46; 95% CI: 0.29 to
	studies in			nonrandomized	longest follow-			0.75; p=0.01). These
	patients			studies), and (3)	up was			benefits were
	undergoing			clinical trial in	abstracted), (3)			associated with
	CV surgery.			patients undergoing	nonhuman			shorter ICU stay
				CV surgery.	experimental			(WMD=-0.93 d [-
					studies, and (4)			1.27; to 0.58];
					no outcome			p=0.002).
					data as far as
					RRT or death
					are concerned.
Meta-	To evaluate	Meta-	3,359	Inclusion criteria:	N/A	Mortality	Need for RRT,	There was no effect	p=NS	RR: 0.93;	Improvements in serum CrCl
analysis:	the effects of	analysis		parallel-group RCTs			adverse effects	of low-dose dopamine		95% CI:	(4% relative decrease [CI: 1% to

© American College of Cardiology Foundation and American Heart Association, Inc.

low-dose	low-dose			that included any pt.				on mortality (RR:		0.76 to	7%]) and measured CrCl (6%
dopamine	dopamine (≤5			sample, compared				0.96; 95% CI: 0.78 to		1.15 (need	relative increase [CI: 1% to
increases	µg/kg of body			low-dose dopamine				1.19), need for renal		for RRT)	11%]) on d 1 were clinically
urine output	weight per			(≤5 µg/kg of body				replacement therapy			insignificant.
but does not	min) compared			weight per min) with				(RR: 0.93; 95% CI:
prevent	with placebo			placebo or no				0.76 to 1.15), or
renal	or no therapy			therapy, and				adverse events (RR:
dysfunction	in patients			recorded any of the				1.13; 95% CI: 0.90 to
or death.	with or at risk			following outcomes:				1.41). Low-dose
2005 (263)	for ARF.			all-cause mortality,				dopamine increased
				requirement for renal				urine output by 24%
				replacement therapy,				(CI: 14% to 35%) on
				renal physiologic				d 1.
				variables (urine
				output, serum CrCl,
				or measured CrCl on
				d 1-, 2-, or 3- after
				starting therapy), or
				adverse effects. We
				also included trials
				in which patients
				were allocated in
				alternating fashion
				or by hospital
				registry number
				(quasi-
				randomization) and
				trials with
				pharmacologic co-
				interventions (such
				as mannitol,
				diuretics, or
				diltiazem) that were
				equally applied to
				both groups.
Mannitol,	To study	Prospecti	100	Patients who	Excluded from	Need for RRT	Peak serum CrCls	Diuresis occurred in	N/A	N/A	N/A
furosemide,	whether the	ve		manifested either	the study were			93.3% of mannitol-
and	need for			acute oliguric or	patients with			furocemide-dopamine
dopamine	dialysis can be			anuric renal failure	ARF associated			group vs. 10% in
infusion in	avoided by			in the postoperative	with inadequate			diuretics group. 90%
postoperativ	infusion of the			period, with	cardiac output			of diuretics group
e renal	solution of			adequate	and tissue			required dialysis

© American College of Cardiology Foundation and American Heart Association, Inc.

failure	mannitol,			postoperative cardiac	perfusion,			versus only 6.7% of
complicatin	furosemide,			output and tissue	patients who			mannitol-furocemide-
g cardiac	and dopamine			perfusion were	required			dopamine group.
surgery.	in the early			prospectively	preoperative
2000 (264)	postoperative			evaluated and, in	dialysis and
	period in			100 patients, such	patients who
	oliguric renal			acute renal	depended on
	failure.			dysfunction was	dialysis.
				recognized in the
				postoperative period.
Diltiazem	To evaluate	RCT	60	Patients undergoing	Ex ante	Urine output	Excretion of	Cumulative urine	p<0.001	N/A	Diltiazem stimulates urine
may	the influence			elective cardiac	exclusion		alpha-GST,	output in the	(excretion		output, reduces excretion of
preserve	of dopamine			surgery	criteria		alpha(1)-MG, ss-	diltiazem group	of alpha-		alpha-GST and ss-NAG and may
renal tubular	and diltiazem				(screened the d		NAG, and CrCl	(9.0±2.8 L) increased	GST)		be useful to maintain tubular
integrity	on renal				before surgery)			significantly			integrity after cardiac surgery.
after cardiac	function and				were severe LV			compared with
surgery.	markers for				dysfunction			placebo (7.0±1.6 L),
2003 (265)	ARF,				(EF <25%),			but not compared
	including				renal			with dopamine
	urinary alpha-				insufficiency			(7.8±1.8 L). CrCl
	glutathion s-				(creatinine			showed no significant
	transferase				>177 μmol·L–			intergroup
	(alpha-GST),				1), liver			differences. There
	alpha-1-				dysfunction			were no significant
	microglobulin				(aspartate			intergroup differences
	(alpha (1)-				aminotransferas			in alpha (1)-MG
	MG) and N-				e >40 U·L–1 or			excretion. Alpha-GST
	acetyl-ss-				alanine			increased
	glucosaminida				aminotransferas			significantly in the
	se (ss-NAG)				e >40 U·L–1),			placebo (2.1 ± 1.8 to
	after				repeat cardiac			11.4 ± 8.6 micro g x
	extracorporeal				surgery, known			L(-1)) and in the
	circulation.				allergy to			dopamine groups (2.7
					dopamine or			± 1.8 to 13.6 ±14.9
					diltiazem,			micro g x L(-1)), but
					anemia			not in the diltiazem
					(hemoglobin			group (1.8 ± 1.4 to
					<9.0 g·dL–1),			3.2 ± 3.2 micro g x
					insulin-			L(-1)). Forty eight h
					dependent			postoperatively alpha-
					diabetes			GST was significantly
					mellitus and			lower in the diltiazem

© American College of Cardiology Foundation and American Heart Association, Inc.

					use of diuretics			group than in both
					or calcium			other groups.
					antagonists. Ex
					post exclusion
					criteria were
					perioperative
					MI, death, and
					low output
					syndrome
					requiring IABP
					and the use of
					aminoglycoside
					s during the
					study period or
					an intolerance
					to the study
					drug.
Diltiazem	To determine	RCT	330	To be included in the	Patients were	The incidence of	LOS, serum	During the first 5 d	p=NS	N/A	N/A
treatment	whether			study, patients’	excluded if	renal failure,	creatinine or BUN	postoperative d, the 2
does not	diltiazem			hearts had to be in	they had a	mortality rate	levels	groups did not differ
alter renal	treatment			sinus rhythm and the	history of			in terms of serum
function	alters renal			patients had to be at	chronic atrial			creatinine or BUN
after	function in			increased risk for	arrhythmias or			levels. The incidence
thoracic	patients			developing	second-degree			of renal failure was
surgery.	undergoing			postoperative	atrioventricular			0.6% in the diltiazem
2001(266)	major thoracic			arrhythmias, either	block or were			group and 1.2% in the
	surgery.			because they were	taking class I or			placebo group
				scheduled to	class III			(difference was not
				undergo a	antiarrhythmic			significant). There
				pneumonectomy or	drugs or			was no difference in
				were >60 y of age	calcium-			the length of
				and scheduled to	channel			hospitalization or
				have a lobectomy.	blockers for			mortality rate.
					ischemic heart
					disease.
					Patients who
					developed new
					signs of
					myocardial
					ischemia or
					infarction or
					who required
© American College of Cardiology Foundation and American Heart Association, Inc.

inotropic support on arrival to the postanesthesia care unit were also excluded.

AKI indicates acute kidney injury; alpha-GST, alpha-glutathion s-transferase, ARF, acute renal failure; ARI, acute renal injury; ATN, acute tubular necrosis; BUN, blood urea nitrogen;CI, confidence interval; CKD, chronic kidney disease; CK-MB, creatinine-kinase myocardial band; CPB, cardiopulmonary bypass; CrCl, Creatinine Clearance; CV, cardiovascular; d, day; EF, ejection fraction; ESRD, end-stage renal disease; IABP, intra aortic balloon pump, ICU, intensive care unit; IV, intravenous; LOS, length of stay; LV, left ventricular; MAP, mean arterial pressure; MI, myocardial infarction; N/A, not applicable; NAC, N-Acetylcysteine; NS, non significant; NYHA, New York Heart Association; OR, odds ratio; RCT, randomized controlled trial; RR, relative risk; RRT, renal replacement therapy; ss-NAG, N-acetyl-ss-glucosaminidase; U, unit; and WMD, weighted mean difference.

Data Supplement 38. Renal Dysfunction

Article Title	Aim of	Study	Study	Patient Population/Inclusion & Exclusion		Endpoints		Statistical Analysis	P Values &	OR / HR /	Study Summary
	Study	Type	Size	Criteria				Reported	95% CI	RR
				Inclusion Criteria	Exclusion Criteria	Primary	Secondary
						Endpoint	Endpoint
OPCAB and	To	Meta-	27,806	RCTs and	Studies involving	Incidence of	Peak	The pooled effect from	p<0.001 for	OR: 0.61;	In the observational
AKI: a meta-	critically	analysis		observational studies	patients with ESRD	overall AKI (as	postoperative	both RCT and	both	95% CI: 0.45	cohort, both overall
analysis of	evaluate			comparing OPCAB	on long term RRT	reported by	serum creatinine	observational studies	incidence of	to 0.8 for	AKI (OR: 0.61; 95%
randomized	the			with CAB in adult	were excluded.	individual study	level, nadir	showed a significant	overall AKI	incidence of	CI: 0.45 to 0.81;
and	outcomes			(>18 y) patients. To	Studies for which	definitions),	postoperative	reduction in overall AKI	and incidence	AKI, OR:	p<0.001) and AKI
observational	and			be included, studies	exclusion of RRT-	incidence of	Crcl, and change	(OR: 0.57; 95% CI: 0.43	of AKI	0.54; 95% CI:	requiring RRT (OR:
studies. 2009	conduct of			had to report at least 1	dependent patients	AKI requiring	in postoperative	to 0.76; p<0.001) and AKI	requiring	0.40 to 0.73	0.54; 95% CI: 0.40 to
(267)	clinical			of the following renal	with ESRD could not	RRT.	serum creatinine	requiring RRT (OR: 0.55;	RRT.	for incidence	0.73; p<0.001) were
	trials			outcomes: AKI, AKI	be verified were also		and Crcl from	95% CI: 0.43 to 0.71;		of AKI	significantly less in the
	addressing			requiring RRT, or	excluded.		corresponding	p<0.001) in the OPCAB		requiring	OPCAB group.
	the impact			postoperative serum			preoperative	group compared with the		RRT.
	of			creatinine/Crcl. For			values.	CAB group. In RCTs,
	OPCAB			studies that reported				overall AKI was
	on AKI			data from the same				significantly reduced in
	during the			trial in multiple				the OPCAB group (OR:
	postoperat			publications, only the				0.27; 95% CI: 0.13 to
	ive period.			largest study was				0.54; p<0.001); however,
				included.				no statistically significant
								difference was noted in
								AKI requiring RRT (OR:
								0.31; 95% CI: 0.06 to
								1.59; p=0.2).

© American College of Cardiology Foundation and American Heart Association, Inc.

Coronary	This study RCTs	116	Patients with	N/A	Changes in renal	Clinical	N/A	Serum	N/A	This study suggests
artery bypass	was		nondialysis-dependent		function	outcomes		creatinine,		that on-pump as
grafting with	designed		renal insufficiency					p<0.000;		compared with
or without	to		with a GFR of 60 mL					GFR,		OPCAB is more
CPB in	compare		· min–1 · 1.73 m–2 or					p<0.000		deleterious to renal
patients with	the effect		less undergoing							function in diabetic
preoperative	of off-		primary, elective							patients with
nondialysis	pump and		CABG							nondialysis dependent
dependent	on-pump									renal insufficiency.
renal	techniques
insufficiency:	on renal
A	function
randomized	in patients
study. 2007	with

(268)nondialysi s- dependent renal insufficien cy with a

GFR of 60 mL · min– 1 · 1.73 m– 2 or less

	undergoin
	g primary,
	elective
	CABG
Renal	To	Observa	2,869	(Preoperative CrCl	Patients on dialysis.	Decrease in	N/A	Propensity match.	p=0.2	N/A	No difference in renal
Dysfunction	compare	tional	(158	<60 mL/min) and who		postop Crcl					outcomes between on
in High-Risk	the		OPCA	underwent isolated		>25% or need					and off-pump.
Patients After	incidence		B)	CABG		for RRT
On-Pump and	of
Off-Pump	postoperat
Coronary	ive renal
Artery	dysfunctio
Bypass	n in
Surgery: A	patients
Propensity	with
Score	preoperati
Analysis.	ve renal
2005 (269)	dysfunctio

© American College of Cardiology Foundation and American Heart Association, Inc.

	n
	(OPACB
	vs.on-
	pump)
Coronary	To	Observa	253	Preoperative serum	Patients on dialysis,	Changes in renal	N/A	N/A	p<0.05	N/A	Incidence of RRT
revascularizat	compare	tional		creatinine more than	PVD, emergency	function			Greater		same but reduced
ion with or	the			150 µmol/L	operation, and				increase in		increased serum
without CPB	incidence				reoperation were				creatinine and		creatinine in OPCAB
in patients	of				excluded				urea in the		vs. on-pump.
with	postoperat								on-pump
preoperative	ive renal								group vs.
nondialysis-	dysfunctio								OPCAB
dependent	n in
renal	patients
insufficiency.	with
2001 (270)	preoperati
	ve
	nondialysis
	-dependent
	renal
	insufficienc
	y
	(OPCAB
	vs.onpum
	p)
Does Off-	To	Observa	215	CABG , baseline	N/A	Changes in renal	N/A	N/A	p=0.499		ARF incidence same
Pump	evaluate	tional		creatinine>1.5 mg/dL		function					between on-pump and
Coronary	the impact										OPCAB.
Surgery	of CPB on
Reduce	the
Postoperative	incidence
ARF? The	of
Importance of	postoperat
Preoperative	ive ARF.
Renal
Function.
(271)

AKI indicates acute kidney injury; ARF, acute renal failure; CABG, coronary artery bypass graft; CI, confidence interval; CPB, cardiopulmonary bypass; Crcl, creatinine clearance; ESRD, end-stage renal disease; GFR, glomerular filtration rate; HR, hazard ratio; ICU, intensive care unit; N/A, not applicable; OPCAB, off-pump coronary artery bypass; OR, odds ratio; PVD, peripheral vascular disease; RCT, randomized controlled trial; RR, relative risk; and RRT, renal replacement therapy.

© American College of Cardiology Foundation and American Heart Association, Inc.