BACKGROUND We aimed to investigate the relationship between the perioperative hemodynamic parameters and the occurrence of cardiac surgery-associated acute kidney injury. METHODS A retrospective study was performed in patients who underwent cardiac surgery at a tertiary referral teaching hospital. Acute kidney injury was determined according to the KDIGO criteria. We investigated the association between the perioperative hemodynamic parameters and cardiac surgery-associated acute kidney injury to identify the independent hemodynamic predictors for acute kidney injury. Subgroup analysis was further performed in patients with chronic hypertension. RESULTS Among 300 patients, 29.3% developed acute kidney injury during postoperative intensive care unit period. Multivariate logistic analysis showed the postoperative nadir diastolic perfusion pressure, but not mean arterial pressure, central venous pressure and mean perfusion pressure, was independently linked to the development of acute kidney injury after cardiac surgery (odds ratio 0.945, P = 0.045). Subgroup analyses in hypertensive subjects (n = 91) showed the postoperative nadir diastolic perfusion pressure and peak central venous pressure were both independently related to the development of acute kidney injury (nadir diastolic perfusion pressure, odds ratio 0.886, P = 0.033; peak central venous pressure, odds ratio 1.328, P = 0.010, respectively). CONCLUSIONS Postoperative nadir diastolic perfusion pressure was independently associated with the development of cardiac surgery-associated acute kidney injury. Furthermore, central venous pressure should be considered as a potential hemodynamic target for hypertensive patients undergoing cardiac surgery.

中文翻译：

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回顾性分析，术后心脏舒张期灌注压与急性肾损伤的发生有关。

背景技术我们旨在研究围手术期血流动力学参数与心脏手术相关的急性肾损伤的发生之间的关系。方法对三级转诊教学医院接受心脏手术的患者进行回顾性研究。根据KDIGO标准确定急性肾损伤。我们调查围手术期血流动力学参数和心脏手术相关的急性肾损伤之间的关联，以确定急性肾损伤的独立的血流动力学预测指标。在慢性高血压患者中进一步进行了亚组分析。结果在300例患者中，有29.3％在术后重症监护病房期间发生了急性肾损伤。多因素logistic分析显示术后最低舒张压灌注压，但平均动脉压，中心静脉压和平均灌注压并非独立于心脏手术后急性肾损伤的发生（几率之比为0.945，P = 0.045）。高血压受试者（n = 91）的亚组分析显示，术后最低舒张压和峰值中心静脉压均与急性肾损伤的发展独立相关（最低舒张压，比值比为0.886，P = 0.033；中心静脉峰值压力，比值比为1.328，P = 0.010）。结论术后最低舒张期灌注压与心脏手术相关的急性肾损伤的发生独立相关。此外，