Background: There are six widely used equations to calculate the
estimated glomerular filtration rate (eGFR) of patients. We aimed to assess the
predictive power of preoperative eGFR calculated by these equations for the
occurrence of postoperative acute kidney injury (AKI). Methods: Patients
who underwent isolated coronary surgery from January 2016 to January 2021 were
continuously enrolled. Serum creatinine and cystatin C used to calculate eGFR
were both measured within 1 week before surgery. The eGFR was calculated using
six equations: Cockcroft Gault (CG) equation, Chinese abbreviated modification of
diet in renal disease (MDRD) equation, chronic kidney disease-epidemiology
(CKD-EPI) equation, and full age spectrum (FAS) equation. Postoperative AKI was
diagnosed by Kidney Disease Improving Global Outcomes criteria (KDIGO)
(① urine volume 0.5 mL/kg/h for 6 h; ② an increase in serum
creatinine by 26.5 µmol/L within 48 h; ③ an increase in
serum creatinine to 1.5 times baseline levels, which is known or presumed
to have occurred within the prior 7 days), and the occurrence of AKI within 7
days after surgery was followed. Results: A total of 1428 patients were
included, of which 319 patients (25.5%) developed postoperative AKI. After
adjustment, all eGFRs (CG OR = 0.983, MDRD OR = 0.983, CKD-EPI OR =
0.97, CKD-EPI OR = 0.955, FAS OR = 0.978, FAS OR = 0.
941, all p 0.001) were significantly associated with AKI. The area
under the receiver operating characteristic curve (AUC) was 0.621 for CG, 0.614
for MDRD, 0.643 for CKD-EPI, 0.739 for CKD-EPI, 0.643 for
FAS, 0.744 for FAS, respectively. There was no difference in
predictive power between FAS and CKD-EPI (p = 0.33,
DeLong’s test). Conclusions: Preoperative eGFR calculated by FAS and CKD-EPI equations have better performance in predicting AKI after
off-pump coronary artery bypass grafting than other equations.
