The Effect of Acute Kidney Injury on TGF-β1 and Smad3 in Patients with Coronary Heart Disease after Off-Pump Coronary Artery Bypass Grafting

Background. Acute kidney injury (AKI) is one of the most common and serious complications for coronary disease (CAD) patients, suffering from coronary artery bypass surgery (CABG). AKI occurs in nearly 30% of cardiac surgery patients, including CABG patients, affecting renal function, prolonging hospitalization time, and increasing all-cause mortality. TGF-β1 and Smad3 are sensitive biomarkers in evaluating kidney function. Therefore, comparing the TGF-β1 and Smad3 levels between the AKI patients and non-AKI patients after CABG surgery might have an important significance for identifying the risk degree of AKI and applying effective preventive measures after CABG surgery. Objective. This study aims at comparing the TGF-β1 and Smad3 levels between the AKI patients and non-AKI patients after CABG surgery to identify the risk degree of AKI and apply effective preventive measures after CABG surgery in clinics. Materials and Methods. A total of 25 proper patients, diagnosed as coronary disease (CAD) and undergoing AKI after CABG, were selected as the AKI group. The 25 participants, who did not suffer from AKI after CABG, were recruited using the case-control matching method in SPSS 25.0 software as the non-AKI group. Also, corresponding surgical specimens (tissues) and samples of blood were collected from them. Histopathological analysis and immunofluorescent microscopy of lesion artery and kidney of patients, who have been treated with kidney transplants, were performed on surgical specimens to find the pathological and histological change difference between the two groups. RT-PCR and Western blot were conducted to quantify the levels of TGF-β1 and Smad3 expression in serum for the patients of AKI and non-AKI groups, respectively. Results. Serious renal fibrosis was noted in patients of the AKI group. In addition, by H&E staining of the lesion artery, severe histopathological changes including smooth muscles proliferation with endothelial cell infiltration, focal degeneration and disruptions, and less collagen accumulation were found in the lesion artery of patients from the AKI group. Higher levels of TGF-β1 and Smad3 were observed in serum of patients of the AKI group. Conclusion: The increased levels of TGF-β1 and Smad3 in serum might be risk factors for triggering AKI for CAD patients undergoing CABG.

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SP244A COMPARISON OF DEFINITIONS (RIFLE, AKIN, AND KDIGO) OF ACUTE KIDNEY INJURY FOR PREDICTION OF OUTCOMES IN ADULTS AFTER ISOLATED CORONARY ARTERY BYPASS GRAFT(CABG) SURGERY

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfz103.sp244 ◽

2019 ◽

Vol 34 (Supplement_1) ◽

Author(s):

sonia Yaqub ◽

Kashif Kazmi,kashif ◽

Hasanat Sharif ◽

Shiraz Hashmi

Keyword(s):

Acute Kidney Injury ◽

Coronary Artery ◽

Coronary Artery Bypass Graft ◽

Coronary Artery Bypass ◽

Artery Bypass ◽

Bypass Graft ◽

Kidney Injury ◽

Artery Bypass Graft ◽

Cabg Surgery

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Urine Output during Cardiopulmonary Bypass Predicts Acute Kidney Injury after Coronary Artery Bypass Grafting

The Heart Surgery Forum ◽

10.1532/hsf.1495 ◽

2016 ◽

Vol 19 (6) ◽

pp. 289 ◽

Cited By ~ 2

Author(s):

Mehmet Yilmaz ◽

Rezan Aksoy ◽

Vildan Kilic Yilmaz ◽

Canan Balci ◽

Cagri Duzyol ◽

...

Keyword(s):

Acute Kidney Injury ◽

Cardiopulmonary Bypass ◽

Coronary Artery ◽

Coronary Artery Bypass Grafting ◽

Coronary Artery Bypass ◽

Urine Output ◽

Artery Bypass ◽

Kidney Injury ◽

Urinary Output ◽

Bypass Grafting

Objective: This study evaluated the relationship between the amount of urinary output during cardiopulmonary bypass and acute kidney injury in the postoperative period of coronary artery bypass grafting.Methods: Two hundred patients with normal preoperative serum creatinine levels, operated on with isolated CABG between 2012-2014 were investigated retrospectively. The RIFLE (Risk, injury, failure, loss of function, and end-stage renal disease) risk scores were calculated for each patient in the third postoperative day. Patients were distributed into two groups in relation to the presence of acute kidney injury or not and these two groups were compared.Results: The urinary output (mL/kg/hour) during cardiopulmonary bypass in the acute kidney injury negative group was significantly higher than in the acute kidney injury positive group (P = .022). In case of a urinary output value 3.70 and lower to predict acute kidney injury positivity, sensitivity was detected as 71.43%. Results of the analysis for urinary output predict positivity of acute kidney injury.Conclusion: We suggest that urine output during cardiopulmonary bypass is a significant criteria that could predict acute kidney injury following coronary artery bypass grafting with cardiopulmonary bypass. Attempts to increase the urine output during cardiopulmonary bypass could help to maintain the renal functions during and after surgery.

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Study to Evaluate the Efficacy of ASP1128 (MA-0217) in Subjects at Risk for Acute Kidney Injury Following Coronary Artery Bypass Graft (CABG) and/or Valve Surgery

Case Medical Research ◽

10.31525/ct1-nct03941483 ◽

2019 ◽

Author(s):

Keyword(s):

At Risk ◽

Acute Kidney Injury ◽

Coronary Artery ◽

Coronary Artery Bypass Graft ◽

Coronary Artery Bypass ◽

Artery Bypass ◽

Bypass Graft ◽

Kidney Injury ◽

Valve Surgery ◽

Artery Bypass Graft

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Faculty Opinions recommendation of Prevention of acute kidney injury by erythropoietin in patients undergoing coronary artery bypass grafting: a pilot study.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.1162244.622723 ◽

2009 ◽

Author(s):

Robert Anderson

Keyword(s):

Acute Kidney Injury ◽

Coronary Artery ◽

Coronary Artery Bypass Grafting ◽

Pilot Study ◽

Coronary Artery Bypass ◽

Artery Bypass ◽

Kidney Injury ◽

Bypass Grafting ◽

Artery Bypass Grafting

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Faculty Opinions recommendation of Preoperative anemia in patients undergoing coronary artery bypass grafting predicts acute kidney injury.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.3713962.3438062 ◽

2010 ◽

Author(s):

John Augoustides ◽

Tygh Wyckoff

Keyword(s):

Acute Kidney Injury ◽

Coronary Artery ◽

Coronary Artery Bypass Grafting ◽

Coronary Artery Bypass ◽

Artery Bypass ◽

Kidney Injury ◽

Bypass Grafting ◽

Preoperative Anemia ◽

Artery Bypass Grafting

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Association between preoperative level of hemoglobin A1c and the incidence of acute kindey injury after coronary artery bypass grafting surgery: a cohort study

Ain-Shams Journal of Anesthesiology ◽

10.1186/s42077-021-00161-7 ◽

2021 ◽

Vol 13 (1) ◽

Author(s):

Ghada Mohamed Samir ◽

Omar Mohamed Ali Mohamed Omar ◽

Madiha Metwally Zidan ◽

Hazem Abd El Rahman Fawzy ◽

Marwa Mamdouh Mohamed El Far

Keyword(s):

Acute Kidney Injury ◽

Coronary Artery ◽

Coronary Artery Bypass Grafting ◽

Coronary Artery Bypass ◽

Hemoglobin A1c ◽

Artery Bypass ◽

Kidney Injury ◽

P Value ◽

Bypass Grafting ◽

Artery Bypass Grafting

Abstract Background The development of acute kidney injury (AKI) is an important indicator of clinical outcomes after cardiac surgery. Elevated preoperative hemoglobin A1c level may be associated with acute kidney injury in patients undergoing coronary artery bypass grafting. This study will investigate the association of preoperative HbA1c levels with AKI after isolated coronary artery bypass grafting (CABG). Results Forty patients undergoing elective CABG were enrolled in this cohort study. Patients are divided into 2 equal groups who underwent isolated coronary artery bypass grafting (CABG): patients with preoperative HbA1c 5.7–6.4% (group A) (prediabetics) and patients with preoperative HbA1c > or = 6.5% (group B) (diabetics). Acute kidney injury according to the Kidney Disease: Improving Global Outcomes criteria developed in 11 patients (27.5%). There was a significant difference between the two groups as regards postoperative urinary NGAL, creatinine level on the 1st day, creatinine level on the 2nd day, urine output on the 1st day, and urine output on the 2nd day (p value was 0.001, 0.002, 0.006, 0.0002, and 0.012 respectively). Postoperative ICU stay duration was statistically significant in the diabetic group (P value 0.009). The need for renal replacement therapy was higher in the diabetic group, but it was not statistically significant between the two groups. Roc analysis shows AUC 0.922 with a significant p value (< 0.0001) and cut of value (≥ 7) with sensitivity 81.82 and specificity 93.10. Conclusion This study revealed that elevated preoperative HbA1c level above 7% showed an increase in incidence of post CABG acute kidney injury along with increase length of postoperative ICU stay.

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Platelet Counts, Acute Kidney Injury, and Mortality after Coronary Artery Bypass Grafting Surgery

Anesthesiology ◽

10.1097/aln.0000000000000959 ◽

2016 ◽

Vol 124 (2) ◽

pp. 339-352 ◽

Cited By ~ 43

Author(s):

Miklos D. Kertai ◽

Shan Zhou ◽

Jörn A. Karhausen ◽

Mary Cooter ◽

Edmund Jooste ◽

...

Keyword(s):

Acute Kidney Injury ◽

Coronary Artery ◽

Coronary Artery Bypass Grafting ◽

Odds Ratio ◽

Artery Bypass ◽

Kidney Injury ◽

Bypass Grafting ◽

Cabg Surgery ◽

Platelet Counts ◽

Postoperative Aki

Abstract Background Cardiac surgery requiring cardiopulmonary bypass is associated with platelet activation. Because platelets are increasingly recognized as important effectors of ischemia and end-organ inflammatory injury, the authors explored whether postoperative nadir platelet counts are associated with acute kidney injury (AKI) and mortality after coronary artery bypass grafting (CABG) surgery. Methods The authors evaluated 4,217 adult patients who underwent CABG surgery. Postoperative nadir platelet counts were defined as the lowest in-hospital values and were used as a continuous predictor of postoperative AKI and mortality. Nadir values in the lowest 10th percentile were also used as a categorical predictor. Multivariable logistic regression and Cox proportional hazard models examined the association between postoperative platelet counts, postoperative AKI, and mortality. Results The median postoperative nadir platelet count was 121 × 109/l. The incidence of postoperative AKI was 54%, including 9.5% (215 patients) and 3.4% (76 patients) who experienced stages II and III AKI, respectively. For every 30 × 109/l decrease in platelet counts, the risk for postoperative AKI increased by 14% (adjusted odds ratio, 1.14; 95% CI, 1.09 to 1.20; P < 0.0001). Patients with platelet counts in the lowest 10th percentile were three times more likely to progress to a higher severity of postoperative AKI (adjusted proportional odds ratio, 3.04; 95% CI, 2.26 to 4.07; P < 0.0001) and had associated increased risk for mortality immediately after surgery (adjusted hazard ratio, 5.46; 95% CI, 3.79 to 7.89; P < 0.0001). Conclusion The authors found a significant association between postoperative nadir platelet counts and AKI and short-term mortality after CABG surgery.

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