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Renal injury in cardiac surgery

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https://www.readbyqxmd.com/read/29028633/acute-kidney-injury-in-congenital-heart-disease
#1
Katja M Gist, David M Kwiatkowski, David S Cooper
PURPOSE OF REVIEW: Acute kidney injury (AKI) is associated with significant morbidity and mortality in patients with congenital heart disease undergoing cardiac surgery or in pediatric patients with congestive heart failure. RECENT FINDINGS: This review describes the definition and various manifestations of AKI, the impact of biomarkers on the diagnosis of AKI, the importance of fluid overload as a consequence of AKI and its long-term impact. SUMMARY: There are novel biomarkers for AKI detection that should facilitate early recognition and intervention to prevent or attenuate the effects of AKI and fluid overload...
October 11, 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/28994685/rhabdomyolysis-and-compartment-syndrome-in-a-bodybuilder-undergoing-minimally-invasive-cardiac-surgery
#2
Sebastian John Baxter, Madhusudan Rao Puchakayala, Vinayak N Bapat
Rhabdomyolysis is the result of skeletal muscle tissue injury and is characterized by elevated creatine kinase levels, muscle pain, and myoglobinuria. It is caused by crush injuries, hyperthermia, drugs, toxins, and abnormal metabolic states. This is often difficult to diagnose perioperatively and can result in renal failure and compartment syndrome if not promptly treated. We report a rare case of inadvertent rhabdomyolysis and compartment syndrome in a bodybuilder undergoing minimally invasive cardiac surgery...
October 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28994186/chronic-kidney-disease-with-comorbid-cardiac-dysfunction-exacerbates-cardiac-and-renal-damage
#3
Shan Liu, Bing H Wang, Darren J Kelly, Henry Krum, Andrew R Kompa
To address the pathophysiological mechanisms underlying chronic kidney disease with comorbid cardiac dysfunction, we investigated renal and cardiac, functional and structural damage when myocardial infarction (MI) was applied in the setting of kidney injury (induced by 5/6 nephrectomy-STNx). STNx or Sham surgery was induced in male Sprague-Dawley rats with MI or Sham surgery performed 4 weeks later. Rats were maintained for a further 8 weeks. Rats (n = 36) were randomized into four groups: Sham+Sham, Sham+MI, STNx+Sham and STNx+MI...
October 10, 2017: Journal of Cellular and Molecular Medicine
https://www.readbyqxmd.com/read/28992285/remote-ischaemic-preconditioning-for-renal-and-cardiac-protection-in-adult-patients-undergoing-cardiac-surgery-with-cardiopulmonary-bypass-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#4
Giacomo Deferrari, Alice Bonanni, Maurizio Bruschi, Cristiano Alicino, Alessio Signori
Background: The main aim of this systematic review was to assess whether remote ischaemic preconditioning (RIPC) protects kidneys and the heart in cardiac surgery with cardiopulmonary bypass (CPB) and to investigate a possible role of anaesthetic agents. Methods: Randomized clinical trials (RCTs) on the effects of RIPC through limb ischaemia in adult patients undergoing cardiac surgery with CPB were searched (1965-October 2016) in PubMed, Cochrane Library and article reference lists...
July 19, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28982674/haptoglobin-2-2-phenotype-is-associated-with-increased-acute-kidney-injury-after-elective-cardiac-surgery-in-patients-with-diabetes-mellitus
#5
Chenzhuo Feng, Bhiken I Naik, Wenjun Xin, Jennie Z Ma, David C Scalzo, Swapna Thammishetti, Robert H Thiele, Zhiyi Zuo, Jacob Raphael
BACKGROUND: Recent studies reported an association between the 2-2 phenotype of haptoglobin (Hp 2-2) and increased cardiorenal morbidity in nonsurgical diabetic patients. Our goal was to determine whether the Hp 2-2 phenotype was associated with acute kidney injury (AKI) after elective cardiac surgery in patients with diabetes mellitus. METHODS AND RESULTS: We prospectively enrolled 99 diabetic patients requiring elective cardiac surgery with cardiopulmonary bypass...
October 5, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28951218/reference-change-values-of-plasma-and-urine-ngal-in-cardiac-surgery-with-cardiopulmonary-bypass
#6
Aurélien Bataille, Ambre Tiepolo, Tiphaine Robert, Anne Boutten, Dan Longrois, Monique Dehoux, Sophie Provenchère
OBJECTIVE: As with any biomarker, interpretation of changes of NGAL concentration must consider its variability in a specific clinical setting. The aim of this study was to calculate the reference change value (RCV) and the index of individuality (II) of plasma and urine NGAL in the context of coronary artery bypass graft surgery with cardiopulmonary bypass, in patients without postoperative acute kidney injury. METHODS: This prospective single-center observational study included patients with a preoperative glomerular filtration rate of >30mlmin(-1) 1...
September 23, 2017: Clinical Biochemistry
https://www.readbyqxmd.com/read/28913500/neuroendocrine-stress-response-implications-for-cardiac-surgery-associated-acute-kidney-injury
#7
REVIEW
J Mauricio Del Rio, Alina Nicoara, Madhav Swaminathan
Surgical stress causes biochemical and physiologic perturbations of every homeostatic axis. These alterations include volume/baroreceptor regulation, sympathetic activation, parasympathetic suppression, neuroendocrine activation, acute phase response protein synthesis and secretion, immune response modulation and long-term behavioral adaptation. The kidney is central to the stress response because of its main role in the maintenance of water, electrolyte balance and hence, intracellular and extracellular compartments, including the intravascular volume...
April 2017: Rom J Anaesth Intensive Care
https://www.readbyqxmd.com/read/28889829/neutrophil-gelatinase-associated-lipocalin-reflects-inflammation-and-is-not-a-reliable-renal-biomarker-in-neonates-and-infants-after-cardiopulmonary-bypass-a-prospective-case-control-study
#8
Karl Reiter, Gunter Balling, Vittorio Bonelli, Jelena Pabst von Ohain, Siegmund Lorenz Braun, Peter Ewert, Bettina Ruf
Introduction Acute kidney injury is a frequent complication after cardiac surgery with cardiopulmonary bypass in infants. Neutrophil gelatinase-associated lipocalin has been suggested to be a promising early biomarker of impending acute kidney injury. On the other hand, neutrophil gelatinase-associated lipocalin has been shown to be elevated in systemic inflammatory diseases without renal impairment. In this secondary analysis of data from our previous study on acute kidney injury after infant cardiac surgery, our hypothesis was that neutrophil gelatinase-associated lipocalin may be associated with surgery-related inflammation...
September 11, 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/28883853/cardiac-surgery-related-cardio-renal-syndrome-assessed-by-conventional-and-novel-biomarkers-under-or-overestimated-diagnosis
#9
Jowita Biernawska, Joanna Bober, Katarzyna Kotfis, Anna Bogacka, Edyta Barnik, Maciej Żukowski
INTRODUCTION: Serum creatinine is a 'gold standard' criterion of recognizing and staging of acute kidney injury (AKI) despite it being a suboptimal, delayed indicator. The interpretation of increased values of biomarkers imposes great difficulty regarding cardiac surgery procedures performed with cardiopulmonary bypass and may lead to under- or overestimated diagnosis. The aim of this study was to evaluate the clinical utility of the sole serum creatinine or urine neutrophil gelatinase-associated lipocalin (NGAL) concentration used for identification of patients with AKI after cardiac surgery...
August 2017: Archives of Medical Science: AMS
https://www.readbyqxmd.com/read/28869251/cardiac-surgery-associated-acute-kidney-injury-risk-factors-pathophysiology-and-treatment
#10
REVIEW
Ying Wang, Rinaldo Bellomo
Cardiac surgery-associated acute kidney injury (CSA-AKI) is the most common clinically important complication in adult patients undergoing open heart surgery, and is associated with increased mortality and morbidity. In patients in intensive care units, CSA-AKI is the second most common type of AKI after septic AKI. In this Review, we explore the definition of CSA-AKI, discuss its epidemiology and identify its risk factors. We discuss current theories of the pathophysiology of CSA-AKI and describe its clinical course...
September 4, 2017: Nature Reviews. Nephrology
https://www.readbyqxmd.com/read/28868314/cause-of-death-following-surgery-for-acute-type-a-dissection-evidence-from-the-canadian-thoracic-aortic-collaborative
#11
R Scott McClure, Maral Ouzounian, Munir Boodhwani, Ismail El-Hamamsy, Michael W A Chu, Zlatko Pozeg, Francois Dagenais, Khokan C Sikdar, Jehangir J Appoo
BACKGROUND: Surgery confers the best chance of survival following acute Type A dissection (ATAD), yet perioperative mortality remains high. Although perioperative risk factors for mortality have been described, information on the actual causes of death is sparse. In this study, we aimed to characterize the inciting events causing death during surgical repair of ATAD. METHODS: Nine centers participated in the study. We included all patients who died following surgical repair for ATAD between January 2007 and December 2013...
April 2017: Aorta (Stamford, Conn.)
https://www.readbyqxmd.com/read/28868295/urinary-mitochondrial-dna-level-as-a-biomarker-of-acute-kidney-injury-severity
#12
Phoebe Wing-Lam Ho, Wing-Fai Pang, Cathy Choi-Wan Luk, Jack Kit-Chung Ng, Kai-Ming Chow, Bonnie Ching-Ha Kwan, Philip Kam-Tao Li, Cheuk-Chun Szeto
BACKGROUND: Mitochondrial dysfunction contributes to the pathogenesis of acute kidney injury (AKI). The urinary mitochondrial DNA (mtDNA) level was previously shown to predict renal function recovery in AKI following cardiac surgery. Herein, we determine whether urinary mtDNA is a marker of severity and predictor of recovery in AKI due to other etiologies. METHODS: We recruited 107 AKI patients. The urinary mtDNA level was measured, the severity of AKI was quantified, and patients were followed for 90 days...
July 2017: Kidney Diseases
https://www.readbyqxmd.com/read/28865484/renal-ultrasound-provides-low-utility-in-evaluating-cardiac-surgery-associated-acute-kidney-injury
#13
Allen Young, Todd Crawford, Alejandro Suarez Pierre, J Trent Magruder, Charles Fraser, John Conte, Glenn Whitman, Christopher Sciortino
BACKGROUND: Renal ultrasonography is part of the algorithm in assessing acute kidney injury (AKI). The purpose of this study was to assess the clinical utility of renal US in postoperative cardiac patients who develop AKI. METHODS: We conducted a retrospective study of 90 postoperative cardiac surgery patients at a single institution from 1/19/2010 to 3/19/2016 who underwent renal US for AKI. We reviewed provider documentation to determine whether renal US changed management...
September 2, 2017: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28863013/cell-free-plasma-hemoglobin-and-male-gender-are-risk-factors-for-acute-kidney-injury-in-low-risk-children-undergoing-cardiopulmonary-bypass
#14
Nahmah Kim-Campbell, Catherine Gretchen, Clifton Callaway, Kathryn Felmet, Patrick M Kochanek, Timothy Maul, Peter Wearden, Mahesh Sharma, Melita Viegas, Ricardo Munoz, Mark T Gladwin, Hülya Bayir
OBJECTIVES: To determine the relationship between the production of cell-free plasma hemoglobin and acute kidney injury in infants and children undergoing cardiopulmonary bypass for cardiac surgery. DESIGN: Prospective observational study. SETTING: Twelve-bed cardiac ICU in a university-affiliated children's hospital. PATIENTS: Children were prospectively enrolled during their preoperative outpatient appointment with the following criteria: greater than 1 month to less than 18 years old, procedures requiring cardiopulmonary bypass, no preexisting renal dysfunction...
November 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28858859/independent-risk-factors-and-2-year-outcomes-of-acute-kidney-injury-after-surgery-for-congenital-heart-disease
#15
Daishi Hirano, Akira Ito, Akifumi Yamada, Daisuke Kakegawa, Saori Miwa, Chisato Umeda, Kosuke Chiba, Yoichi Takemasa, Ai Tokunaga, Hiroyuki Ida
BACKGROUND: Data are limited regarding risk factors for acute kidney injury (AKI) following cardiac surgery in children with congenital heart disease (CHD). This observational study was performed to examine temporal trends in AKI incidence according to the Pediatric Risk, Injury, Failure, Loss, End-Stage Renal Disease (pRIFLE) criteria, identify independent risk factors for AKI after cardiac surgery, and examine associations between AKI and long-term mortality. METHODS: We retrospectively evaluated 418 patients (259 males, 159 females; median age, 5 months) who underwent cardiac surgery for CHD between April 2007 and August 2013...
2017: American Journal of Nephrology
https://www.readbyqxmd.com/read/28856354/severity-weighting-of-postoperative-adverse-events-in-orthopedic-surgery
#16
Daniel D Bohl, Junyoung Ahn, Adam M Lukasiewicz, Andre M Samuel, Matthew L Webb, Bryce A Basques, Nicholas S Golinvaux, Kern Singh, Jonathan N Grauer
Studies of adverse events (AEs) after orthopedic surgery commonly use composite AE outcomes. An example of such an outcome is any AE. These types of outcomes treat AEs with different clinical significance (eg, death, urinary tract infection) similarly. We conducted a study to address this shortcoming in research methodology by creating a single severity-weighted outcome that can be used to characterize the overall severity of a given patient's postoperative course. All orthopedic faculty members at 2 academic institutions were invited to complete a severity-weighting exercise in which AEs were assigned a percentage severity of death...
July 2017: American Journal of Orthopedics
https://www.readbyqxmd.com/read/28831235/benign-heart-murmurs-as-a-predictor-for-complications-following-total-joint-arthroplasty
#17
James M Friedman, Ricardo Couso, Michael Kitchens, Venus Vakhshori, Cody D Hillin, Chia H Wu, Joshua Steere, Jaimo Ahn, Eric Hume
BACKGROUND: There is scant literature examining the predictive role of heart murmurs in the absence of suspected structural heart disease on complications of non-cardiac surgery. We hypothesize the detection of heart murmurs in the absence of structural heart disease will help identify patients at risk for complications following total joint arthroplasty (TJA) surgery. METHOD: This was a prospective cohort of patients undergoing TJA over a twenty-month period. The study was performed at a single academic institution with four subspecialty surgeons...
December 2017: Journal of Orthopaedics
https://www.readbyqxmd.com/read/28808078/relationship-of-kidney-injury-biomarkers-with-long-term-cardiovascular-outcomes-after-cardiac-surgery
#18
Chirag R Parikh, Jeremy Puthumana, Michael G Shlipak, Jay L Koyner, Heather Thiessen-Philbrook, Eric McArthur, Kathleen Kerr, Peter Kavsak, Richard P Whitlock, Amit X Garg, Steven G Coca
Clinical AKI, measured by serum creatinine elevation, is associated with long-term risks of adverse cardiovascular (CV) events and mortality in patients after cardiac surgery. To evaluate the relative contributions of urine kidney injury biomarkers and plasma cardiac injury biomarkers in adverse events, we conducted a multicenter prospective cohort study of 968 adults undergoing cardiac surgery. On postoperative days 1-3, we measured five urine biomarkers of kidney injury (IL-18, NGAL, KIM-1, L-FABP, and albumin) and five plasma biomarkers of cardiac injury (NT-proBNP, H-FABP, hs-cTnT, cTnI, and CK-MB)...
August 14, 2017: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/28803772/perioperative-statins-do-not-prevent-acute-kidney-injury-after-cardiac-surgery-a-meta-analysis-of-randomized-controlled-trials
#19
Bing-Cheng Zhao, Pu Shen, Ke-Xuan Liu
OBJECTIVES: To evaluate whether perioperative statins reduce the risk of acute kidney injury (AKI) after cardiac surgery. DESIGN: Systematic review and meta-analysis of randomized trials. SETTING: Perioperative management in hospitals that perform cardiac surgery. PARTICIPANTS: Adult patients undergoing cardiac surgery. INTERVENTIONS: PubMed, EMBASE, and the Cochrane Library databases were searched for randomized trials...
April 21, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28803769/urine-biomarkers-of-tubular-renal-cell-damage-for-the-prediction-of-acute-kidney-injury-after-cardiac-surgery-a-pilot-study
#20
Tanja Mayer, Daniel Bolliger, Markus Scholz, Oliver Reuthebuch, Michael Gregor, Patrick Meier, Martin Grapow, Manfred D Seeberger, Jens Fassl
OBJECTIVE: To evaluate the perioperative course of urine levels of the renal damage biomarkers tissue inhibitor of metalloproteinase 2 (TIMP-2) and insulin-like growth factor-binding protein 7 (IGFBP7) and to evaluate the predictive value of elevated TIMP-2 × IGFBP7 concentrations to predict acute kidney injury (AKI) early after cardiac on-pump surgery. DESIGN: Prospective, observational cohort study. SETTING: University hospital. PARTICIPANTS: The study comprised 110 consecutive patients undergoing elective cardiac surgery with cardiopulmonary bypass (CPB) between January and March 2014...
April 16, 2017: Journal of Cardiothoracic and Vascular Anesthesia
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