{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T17:38:29Z","timestamp":1761845909809,"version":"3.41.2"},"reference-count":23,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2024,11,1]],"date-time":"2024-11-01T00:00:00Z","timestamp":1730419200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/501100005006","name":"Asan Institute for Life Sciences, Asan Medical Center, Seoul","doi-asserted-by":"crossref","award":["2017-0699"],"award-info":[{"award-number":["2017-0699"]}],"id":[{"id":"10.13039\/501100005006","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,11,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>OBJECTIVES<\/jats:title>\n                  <jats:p>To analyse the impact of mild renal dysfunction on the prognosis of patients undergoing valve surgery.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS<\/jats:title>\n                  <jats:p>A total of 6210 consecutive patients (3238 women; mean age 59.2\u2009\u00b1\u200912.7\u2009years) who underwent left-sided heart valve surgery between 2000 and 2022 were included in the study cohort. The primary outcome was all-cause death, and the secondary outcome was a composite of death, reoperation, stroke and heart failure. The restricted cubic spline function was utilized to investigate the association between estimated glomerular filtration rate and clinical outcomes, which was validated using inverse probability of treatment weighting-adjusted analysis.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>Severities of baseline renal dysfunction were none in 1520 (24.5%), mild in 3557 (57.3%), moderate in 977 (15.7%), severe in 59 (1.0%) and end-stage in 97 (1.6%). Clinical outcomes varied significantly according to the degree of baseline renal dysfunction. The restricted cubic spline function curve showed a non-linear association, indicating that the significantly adverse effects of low estimated glomerular filtration rate on clinical outcomes were diminished in cases of mild renal dysfunction. This finding was corroborated by inverse probability of treatment weighting-adjusted analysis, and subgroup analyses did not show significant differences in clinical outcomes according to the presence of mild renal dysfunction (all-cause mortality, hazard ratio: 1.08; 95% confidence interval 0.90\u20131.28; P\u2009=\u20090.413; composite outcome, hazard ratio: 1.06; 95% confidence interval 0.92\u20131.21; P\u2009=\u20090.421).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>In patients undergoing valve surgery, long-term clinical outcomes were significantly associated with the degree of baseline renal function impairment but not with the presence of mild renal dysfunction, demonstrating a non-linear association between baseline renal function and postoperative outcomes.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ejcts\/ezae409","type":"journal-article","created":{"date-parts":[[2024,11,20]],"date-time":"2024-11-20T19:34:31Z","timestamp":1732131271000},"source":"Crossref","is-referenced-by-count":3,"title":["Prognostic impact of mild renal dysfunction in patients undergoing valve surgery"],"prefix":"10.1093","volume":"66","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4698-7475","authenticated-orcid":false,"given":"Kitae","family":"Kim","sequence":"first","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine , Seoul,","place":["Republic of Korea"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Taeksu","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine , Seoul,","place":["Republic of Korea"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4374-6879","authenticated-orcid":false,"given":"Sungsil","family":"Yoon","sequence":"additional","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine , Seoul,","place":["Republic of Korea"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hong Rae","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine , Seoul,","place":["Republic of Korea"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0809-2240","authenticated-orcid":false,"given":"Ho Jin","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine , Seoul,","place":["Republic of Korea"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pil Je","family":"Kang","sequence":"additional","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine , Seoul,","place":["Republic of Korea"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7008-054X","authenticated-orcid":false,"given":"Jae Suk","family":"Yoo","sequence":"additional","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine , Seoul,","place":["Republic of Korea"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3699-0312","authenticated-orcid":false,"given":"Sung-Ho","family":"Jung","sequence":"additional","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine , Seoul,","place":["Republic of Korea"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8981-6011","authenticated-orcid":false,"given":"Cheol Hyun","family":"Chung","sequence":"additional","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine , Seoul,","place":["Republic of Korea"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5801-2395","authenticated-orcid":false,"given":"Joon Bum","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine , Seoul,","place":["Republic of Korea"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2024,11,20]]},"reference":[{"key":"2024112315252349200_ezae409-B1","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1016\/j.jtcvs.2011.07.057","article-title":"Short- and long-term outcomes in patients undergoing valve surgery with end-stage renal failure receiving chronic hemodialysis","volume":"144","author":"Thourani","year":"2012","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2024112315252349200_ezae409-B2","doi-asserted-by":"crossref","first-page":"1798","DOI":"10.1016\/j.athoracsur.2011.02.015","article-title":"Impact of preoperative renal dysfunction on long-term survival for patients undergoing aortic valve replacement","volume":"91","author":"Thourani","year":"2011","journal-title":"Ann Thorac Surg"},{"key":"2024112315252349200_ezae409-B3","doi-asserted-by":"crossref","first-page":"140","DOI":"10.1016\/j.ahj.2023.01.006","article-title":"Mortality and rehospitalization after mitral valve surgery as a function of age and key comorbidities","volume":"258","author":"Havers-Borgersen","year":"2023","journal-title":"Am Heart J"},{"key":"2024112315252349200_ezae409-B4","doi-asserted-by":"crossref","first-page":"484","DOI":"10.1510\/icvts.2009.203836","article-title":"Microalbuminuria and short-term prognosis in patients undergoing cardiac surgery","volume":"9","author":"Mikkelsen","year":"2009","journal-title":"Interact CardioVasc Thorac Surg"},{"key":"2024112315252349200_ezae409-B5","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1097\/ACO.0000000000000054","article-title":"Perioperative renal function and surgical outcome","volume":"27","author":"Mooney","year":"2014","journal-title":"Curr Opin Anaesthesiol"},{"key":"2024112315252349200_ezae409-B6","first-page":"e35","article-title":"2020 ACC\/AHA Guideline for the Management of Patients with Valvular Heart Disease: executive summary: a report of the American College of Cardiology\/American Heart Association Joint Committee on Clinical Practice Guidelines","volume":"143","author":"Otto","year":"2021","journal-title":"Circulation"},{"key":"2024112315252349200_ezae409-B7","doi-asserted-by":"crossref","first-page":"1270","DOI":"10.1016\/j.jacc.2022.01.035","article-title":"Prognostic impact of mildly impaired renal function in patients undergoing multivessel coronary revascularization","volume":"79","author":"Kim","year":"2022","journal-title":"J Am Coll Cardiol"},{"key":"2024112315252349200_ezae409-B8","doi-asserted-by":"crossref","first-page":"604","DOI":"10.7326\/0003-4819-150-9-200905050-00006","article-title":"A new equation to estimate glomerular filtration rate","volume":"150","author":"Levey","year":"2009","journal-title":"Ann Intern Med"},{"key":"2024112315252349200_ezae409-B9","doi-asserted-by":"crossref","first-page":"713","DOI":"10.1053\/j.ajkd.2014.01.416","article-title":"KDOQI US commentary on the 2012 KDIGO clinical practice guideline for the evaluation and management of CKD","volume":"63","author":"Inker","year":"2014","journal-title":"Am J Kidney Dis"},{"key":"2024112315252349200_ezae409-B10","doi-asserted-by":"crossref","first-page":"3078","DOI":"10.1002\/sim.2781","article-title":"The performance of different propensity score methods for estimating marginal odds ratios","volume":"26","author":"Austin","year":"2007","journal-title":"Stat Med"},{"key":"2024112315252349200_ezae409-B11","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1214\/09-STS313","article-title":"Matching methods for causal inference: a review and a look forward","volume":"25","author":"Stuart","year":"2010","journal-title":"Stat Sci"},{"key":"2024112315252349200_ezae409-B12","doi-asserted-by":"crossref","first-page":"354","DOI":"10.1159\/000111829","article-title":"Chronic kidney disease is associated with angiographic coronary artery disease","volume":"28","author":"Chonchol","year":"2008","journal-title":"Am J Nephrol"},{"key":"2024112315252349200_ezae409-B13","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1016\/S0735-1097(02)02663-3","article-title":"Level of kidney function as a risk factor for atherosclerotic cardiovascular outcomes in the community","volume":"41","author":"Manjunath","year":"2003","journal-title":"J Am Coll Cardiol"},{"key":"2024112315252349200_ezae409-B14","doi-asserted-by":"crossref","first-page":"734","DOI":"10.1093\/ejcts\/ezs043","article-title":"EuroSCORE II","volume":"41","author":"Nashef","year":"2012","journal-title":"Eur J Cardiothorac Surg"},{"key":"2024112315252349200_ezae409-B15","first-page":"299","article-title":"Acute kidney injury based on KDIGO (Kidney Disease Improving Global Outcomes) criteria in patients with elevated baseline serum creatinine undergoing cardiac surgery","volume":"29","author":"Machado","year":"2014","journal-title":"Rev Bras Cir Cardiovasc"},{"key":"2024112315252349200_ezae409-B16","doi-asserted-by":"crossref","first-page":"893","DOI":"10.1016\/j.ahj.2008.06.043","article-title":"The relationship between renal function and outcome from heart valve surgery","volume":"156","author":"Gibson","year":"2008","journal-title":"Am Heart J"},{"key":"2024112315252349200_ezae409-B17","doi-asserted-by":"crossref","first-page":"748","DOI":"10.1510\/icvts.2007.159392","article-title":"Effect of preoperative mild renal dysfunction on mortality and morbidity following valve cardiac surgery","volume":"6","author":"Ib\u00e1\u00f1ez","year":"2007","journal-title":"Interact Cardiovasc Thorac Surg"},{"key":"2024112315252349200_ezae409-B18","doi-asserted-by":"crossref","first-page":"800","DOI":"10.1016\/j.jtcvs.2013.07.073","article-title":"Incidence, dynamics, and prognostic value of acute kidney injury for death after cardiac surgery","volume":"147","author":"Dardashti","year":"2014","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2024112315252349200_ezae409-B19","doi-asserted-by":"crossref","first-page":"1093","DOI":"10.1093\/eurheartj\/ehi830","article-title":"Is pre-operative anaemia a risk marker for in-hospital mortality and morbidity after valve replacement?","volume":"27","author":"Cladellas","year":"2006","journal-title":"Eur Heart J"},{"key":"2024112315252349200_ezae409-B20","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1016\/S0140-6736(00)02456-9","article-title":"Premature cardiovascular disease in chronic renal failure","volume":"356","author":"Baigent","year":"2000","journal-title":"Lancet"},{"key":"2024112315252349200_ezae409-B21","doi-asserted-by":"crossref","first-page":"753","DOI":"10.7326\/0003-4819-126-10-199705150-00001","article-title":"Clarifying the direct relation between total cholesterol levels and death from coronary heart disease in older persons","volume":"126","author":"Corti","year":"1997","journal-title":"Ann Intern Med"},{"key":"2024112315252349200_ezae409-B22","doi-asserted-by":"crossref","first-page":"557","DOI":"10.1161\/01.STR.28.3.557","article-title":"Serum creatinine concentration and risk of cardiovascular disease: a possible marker for increased risk of stroke","volume":"28","author":"Wannamethee","year":"1997","journal-title":"Stroke"},{"key":"2024112315252349200_ezae409-B23","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1186\/s13019-019-0998-4","article-title":"The impact of mild renal dysfunction on isolated cardiopulmonary coronary artery bypass grafting: a retrospective propensity score matching analysis","volume":"14","author":"Wang","year":"2019","journal-title":"J Cardiothorac Surg"}],"container-title":["European Journal of Cardio-Thoracic Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ejcts\/advance-article-pdf\/doi\/10.1093\/ejcts\/ezae409\/60768202\/ezae409.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ejcts\/advance-article-pdf\/doi\/10.1093\/ejcts\/ezae409\/60797522\/ezae409.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ejcts\/advance-article-pdf\/doi\/10.1093\/ejcts\/ezae409\/60797522\/ezae409.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,23]],"date-time":"2024-11-23T15:25:39Z","timestamp":1732375539000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ejcts\/article\/doi\/10.1093\/ejcts\/ezae409\/7905467"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,11]]},"references-count":23,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2024,11,4]]}},"URL":"https:\/\/doi.org\/10.1093\/ejcts\/ezae409","relation":{},"ISSN":["1873-734X"],"issn-type":[{"type":"electronic","value":"1873-734X"}],"subject":[],"published-other":{"date-parts":[[2024,11]]},"published":{"date-parts":[[2024,11]]},"article-number":"ezae409"}}