scholarly journals Use of early postoperative serum creatinine elevation to identify acute kidney injury after cardiac surgery

2017 ◽  
Vol 65 (1) ◽  
pp. 127-128 ◽  
Author(s):  
Hui-Xian Li ◽  
Fu-Shan Xue ◽  
Ya-Yang Liu
2017 ◽  
Vol 20 (5) ◽  
pp. 214 ◽  
Author(s):  
Miha Antonic

Background: Even minor postoperative reductions in renal function influence the outcome of cardiac surgery. The mechanisms of postoperative renal injury in cardiac surgery are multifactorial and include ischemia-reperfusion injury. The study investigates the effect of the antioxidant ascorbic acid on the postoperative acute kidney injury after elective CABG surgery.Methods: A prospective randomized single-center trial was conducted in on-pump coronary artery bypass patients. The patients in the ascorbic acid group received 2 grams of ascorbic acid 24 hours and 2 hours preoperatively and 1 gram twice daily five days after the surgery.  Postoperatively, the subjects were monitored for renal dysfunction and other complications.Results: 100 patients were included, with 50 patients in each study group. The groups were well matched for baseline demographics, preoperative medications, comorbidities, and had similar intraoperative characteristics. The incidence of postoperative acute kidney injury in the ascorbic acid group was 16% and 14% in the control group (P = .779). The groups also did not differ in peak postoperative serum creatinine (83 [33] µmol/L versus 83 [39] µmol/L; P = .434), the lowest postoperative creatinine clearance (96.40 ± 35.78 mL/min versus 90.89 ± 36.18 mL/min; P = .766), and time from surgery to the onset of peak postoperative serum creatinine (1.64 ± 1.34 days versus 1.92 ± 1.54 days; P = .393). There was no dialysis required in any patient. Conclusion: The results of this study did not demonstrate a significant protective effect of ascorbic acid on the incidence of postoperative acute renal injury in elective on-pump CABG patients.


2011 ◽  
Vol 80 (6) ◽  
pp. 655-662 ◽  
Author(s):  
Michael Zappitelli ◽  
Catherine D. Krawczeski ◽  
Prasad Devarajan ◽  
Zhu Wang ◽  
Kyaw Sint ◽  
...  

HPB ◽  
2020 ◽  
Vol 22 (1) ◽  
pp. 144-150
Author(s):  
Gaëtan-Romain Joliat ◽  
Ismail Labgaa ◽  
Nicolas Demartines ◽  
Nermin Halkic

2020 ◽  
Vol 63 (4) ◽  
pp. 151-156
Author(s):  
Hee Sun Baek ◽  
Youngok Lee ◽  
Hea Min Jang ◽  
Joonyong Cho ◽  
Myung Chul Hyun ◽  
...  

Background: Acute kidney injury (AKI) is one of the most significant postoperative complications of pediatric cardiac surgery. Because serum creatinine has limitations as a diagnostic marker of AKI, new biomarkers including neutrophil gelatinase-associated lipocalin (NGAL), kidney injury molecule-1 (KIM-1), and interleukin-18 (IL-18) are being evaluated to overcome these limitations and detect AKI at an early stage after cardiac surgery.Purpose: This study aimed to investigate the clinical usefulness of these biomarkers in young children.Methods: Thirty patients with congenital heart diseases who underwent cardiac surgery using cardiopulmonary bypass (CPB) were selected, and their urine and blood samples were collected at baseline and 6, 24, and 48 hours after surgery. Serum creatinine and blood urea nitrogen levels as well as NGAL, KIM-1, and IL-18 levels in urine samples were measured, and clinical parameters were evaluated.Results: Of the 30 patients, 12 developed AKI within 48 hours after cardiac surgery. In the AKI group, 8 of 12 (66.6%) met AKI criteria after 24 hours, and urine KIM-1/creatinine (Cr) level (with adjustment of urine creatinine) peaked at 24 hours with significant difference from baseline level. Additionally, urine KIM-1/Cr level in the AKI group was significantly higher than in the non-AKI group at 6 hours. However, urine NGAL/Cr and IL-18/Cr levels showed no specific trend with time for 48 hours after cardiac surgery.Conclusion: It is suggested that urine KIM-1/Cr concentration could be considered a good biomarker for early AKI prediction after open cardiac surgery using CPB in young children with congenital heart diseases.


Author(s):  
DIVYA DHARSHINI B ◽  
SMITA PADHY ◽  
GIRIJAVANI D S S ◽  
PAYALA VIJAYA LAKSHMI

Objectives: Acute kidney damage (Acute kidney injury [AKI]) is defined by elevations in serum creatinine levels that occur after surgery. In cardiac surgery, creatinine is a critical determinant. This study highlights the detection of serum creatinine as an early diagnostic and predictive marker of AKI following coronary artery bypass grafting (CABG) and to estimate the serum creatinine concentrations before and at 24 and 48 h after CABG. Methods: It is a single center, Cross-sectional study. Patients from Cardiothoracic and Vascular surgery undergoing CABG in Sri Ramachandra Medical College and Research Institute were included in the study. A total of 80 cases were included in the study. The method used for measurement of serum creatinine is by modification of kinetic Jaffe reaction. Data were analyzed using Stata/SE version 16.0 and represented in terms of means, standard deviation at 95% confidence level and t’ test was performed as statistical analysis and p<0.05 indicates significance. Sigma plot software version 10.0 was used to draw the standard error mean graphs. Results: The serum creatinine values at 24 h after the surgery was statistically higher than the preoperative values at 5% significance level (p=0.04). The serum creatinine values 48 h after the surgery was also statistically higher than the preoperative values at 1% significance level (p=0.001). The serum creatinine values 48 h after surgery are highly significant (p=0.001) when compared to the serum creatinine values 24 h after surgery. Conclusion: Before an increase in serum creatinine level is detected, over 50% of renal function must be lost. It was concluded that serum creatinine is an inadequate and delayed marker of AKI.


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