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Renal injury in cardiac surgery

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https://www.readbyqxmd.com/read/28808078/relationship-of-kidney-injury-biomarkers-with-long-term-cardiovascular-outcomes-after-cardiac-surgery
#1
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
#2
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
#3
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
https://www.readbyqxmd.com/read/28758975/elevated-soluble-urokinase-plasminogen-activator-receptor-and-proenkephalin-serum-levels-predict-the-development-of-acute-kidney-injury-after-cardiac-surgery
#4
Jana C Mossanen, Jessica Pracht, Tobias U Jansen, Lukas Buendgens, Christian Stoppe, Andreas Goetzenich, Joachim Struck, Rüdiger Autschbach, Gernot Marx, Frank Tacke
Acute kidney injury (AKI) develops in up to 40% of patients after cardiac surgery. The soluble urokinase plasminogen activator receptor (suPAR) has been identified as a biomarker for incident chronic kidney disease (CKD). Proenkephalin (proENK) also has been shown to be a biomarker for renal dysfunction. We hypothesized that pre-surgery suPAR and proENK levels might predict AKI in patients undergoing cardiac surgery. Consecutive patients (n = 107) undergoing elective cardiac surgery were studied prospectively...
July 31, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/28748536/renal-tubular-injury-during-cardiopulmonary-bypass-as-assessed-by-urinary-release-of-n-acetyl-%C3%A3-d-glucosaminidase
#5
L Lannemyr, E Lundin, B Reinsfelt, G Bragadottir, B Redfors, J Oras, S-E Ricksten
BACKGROUND: Acute kidney injury (AKI) is a common complication with a major impact on morbidity and mortality after cardiac surgery with cardiopulmonary bypass (CPB). The aim of the present study was to perform a detailed analysis on the release of the tubular injury biomarker N-acetyl-b-D-glucosaminidase (NAG) during and early after CPB and to describe independent predictors of maximal tubular injury. We hypothesized that renal tubular injury occurs early after the onset of CPB. METHODS: In this prospective observational study, we included 61 patients undergoing open cardiac surgery with an expected CPB duration exceeding 60 min...
July 26, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28743566/mortality-prediction-in-patients-with-acute-kidney-injury-requiring-renal-replacement-therapy-after-cardiac-surgery
#6
Inga Skarupskienė, Dalia Adukauskienė, Jurgita Kuzminskienė, Laima Rimkutė, Vilma Balčiuvienė, Edita Žiginskienė, Vytautas Kuzminskis, Agnė Adukauskaitė, Daiva Pentiokinienė, Inga Arūnė Bumblytė
BACKGROUND AND OBJECTIVE: Acute kidney injury (AKI) is a common and potentially serious postoperative complication after cardiac surgery, and it remains a cause of major morbidity and mortality. The aim of our study was to assess the prognostic illness severity score and to estimate the significant risk factors for poor outcome of patients with AKI requiring renal replacement therapy (RRT) after cardiac surgery. MATERIALS AND METHODS: We retrospectively analyzed data of adult (>18 years) patients (n=111) who underwent open heart surgery and had developed AKI with need for RRT...
July 14, 2017: Medicina
https://www.readbyqxmd.com/read/28737097/elevated-levels-of-procalcitonin-and-interleukin-6-are-linked-with-postoperative-complications-in-cardiac-surgery
#7
A Brocca, G M Virzì, M de Cal, D Giavarina, M Carta, C Ronco
BACKGROUND: Cardiac surgery-associated acute kidney injury is a frequent and serious postoperative complication of cardiac surgery and is associated with an increased risk of morbidity, mortality, and length stay. In this study, we hypothesized that persistent elevation in inflammation in the first 48 h might be a powerful predictor of clinical outcome. Our aim was to elucidate the usefulness of interleukin-6 and procalcitonin postoperative levels in predicting mortality and renal complications in cardiac surgery patients...
March 1, 2017: Scandinavian Journal of Surgery: SJS
https://www.readbyqxmd.com/read/28729966/causal-relationship-between-hypoalbuminemia-and-acute-kidney-injury
#8
REVIEW
Christian J Wiedermann, Wolfgang Wiedermann, Michael Joannidis
Our meta-analysis published in 2010 provided evidence that low levels of serum albumin (hypoalbuminemia) are a significant independent predictor of acute kidney injury (AKI) and death following AKI. Since then, a large volume of additional data from observational clinical studies has been published further evaluating the relationship between serum albumin and AKI occurrence. This is an updated review of the literature to re-evaluate the hypothesis that hypoalbuminemia is independently associated with increased AKI risk...
July 6, 2017: World Journal of Nephrology
https://www.readbyqxmd.com/read/28717377/appropriate-blood-component-therapy-can-reduce-postcardiac-surgery-acute-kidney-injury-through-packed-cell-transfusion-reduction
#9
Kianoush Saberi, Mehrdad Salehi, Mehrzad Rahmanian, Ali Reza Bakhshandeh, Gholam Reza Massoumi
BACKGROUND: Acute kidney injury (AKI) can happen due to different factors such as anemia. Packed cell (PC) transfusion is an important cause of AKI occurrence. The aim of the study is to investigate whether appropriate blood component (BC) therapy can reduce blood transfusion and it would result in AKI decreasing. MATERIALS AND METHODS: We conducted a cohort study of 1388 patients who underwent cardiac surgery in one university hospital. A serum creatinine higher than 2 mg/dl, renal disease history, renal replacement therapy (chronic dialysis) were our exclusion criteria...
2017: Journal of Research in Medical Sciences: the Official Journal of Isfahan University of Medical Sciences
https://www.readbyqxmd.com/read/28706864/surgical-outcomes-of-isolated-tricuspid-valve-procedures-repair-versus-replacement
#10
Julius I Ejiofor, Robert C Neely, Maroun Yammine, Siobhan McGurk, Tsuyoshi Kaneko, Marzia Leacche, Lawrence H Cohn, Prem S Shekar
BACKGROUND: Isolated tricuspid valve (ITV) operations are infrequent and the decision to operate is controversial. We report a series of ITV operations to outline the current disease status requiring this uncommon procedure with an emphasis on the results of tricuspid valve repair (TVr) versus replacement (TVR). METHODS: Using our prospective cardiac surgery database, 57 patients who underwent ITV operations between 01/02-03/14 were identified. Median follow up time was 3...
May 2017: Annals of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28701593/neutrophil-gelatinase-associated-lipocalin-as-a-biomarker-for-predicting-acute-kidney-injury-during-off-pump-coronary-artery-bypass-grafting
#11
Muralidhar Kanchi, R Manjunath, Jos Massen, Lloyd Vincent, Kumar Belani
BACKGROUND: Acute kidney injury (AKI) following cardiac surgery is a major complication resulting in increased morbidity, mortality, and economic burden. In this study, we assessed the usefulness of estimating serum neutrophil gelatinase-associated lipocalin (NGAL) as a biomarker in predicting AKI in patients with stable chronic kidney disease (CKD) and undergoing off-pump coronary artery bypass grafting (OP-CABG). PATIENTS AND METHODS: We prospectively studied sixty nondialysis-dependent CKD patients with estimated glomerular filtration rate <60 ml/min/1...
July 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28683730/urinalysis-findings-and-urinary-kidney-injury-biomarker-concentrations
#12
Girish N Nadkarni, Steven G Coca, Allison Meisner, Shanti Patel, Kathleen F Kerr, Uptal D Patel, Jay L Koyner, Amit X Garg, Heather Thiessen Philbrook, Charles L Edelstein, Michael Shlipak, Joe El-Khoury, Chirag R Parikh
INTRODUCTION: Urinary biomarkers of kidney injury are presumed to reflect renal tubular damage. However, their concentrations may be influenced by other factors, such as hematuria or pyuria. We sought to examine what non-injury related urinalysis factors are associated with urinary biomarker levels. METHODS: We examined 714 adults who underwent cardiac surgery in the TRIBE-AKI cohort that did not experience post-operative clinical AKI (patients with serum creatinine change of ≥ 20% were excluded)...
July 6, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28655154/risk-model-for-deaths-and-renal-replacement-therapy-dependence-in-patients-with-acute-kidney-injury-after-cardiac-surgery
#13
Shiren Sun, Feng Ma, Qiaoneng Li, Ming Bai, Yangping Li, Yan Yu, Chen Huang, Hanmin Wang, Xiaoxuan Ning
OBJECTIVES: Acute kidney injury (AKI) is a serious complication after cardiac surgery and is associated with increased in-hospital deaths. Renal replacement therapy (RRT) is becoming a routine strategy for severe AKI. Our goal was to evaluate the risk factors for death and RRT dependence in patients with AKI after cardiac surgery. METHODS: We included 190 eligible adult patients who had AKI following cardiac surgery and who required RRT at our centre from November 2010 to March 2015...
June 23, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28630035/the-effects-of-preoperative-volume-replacement-in-diabetic-patients-undergoing-coronary-artery-bypass-grafting-surgery-protocol-for-a-randomized-controlled-trial-verdict-trial
#14
Madeleine Clout, Tracy Harris, Chris Rogers, Lucy Culliford, Jodi Taylor, Gianni Angelini, Pradeep Narayan, Barnaby Reeves, James Hillier, Kate Ashton, Kunal Sarkar, Raimondo Ascione
BACKGROUND: Diabetes mellitus is a major risk factor for prolonged hospital stays, renal failure, and mortality in patients having coronary artery bypass grafting (CABG). Complications pose a serious threat to patients and prolong intensive care and hospital stays. Low glomerular filtration rate (GFR) due to existing renal impairment or volume depletion may exacerbate acute renal impairment/failure in these patients. Preoperative volume replacement therapy (VRT) is reported to increase the GFR and we hypothesize that VRT will reduce renal impairment and related complications in diabetic patients...
June 19, 2017: JMIR Research Protocols
https://www.readbyqxmd.com/read/28623953/early-versus-late-initiation-of-renal-replacement-therapy-impacts-mortality-in-patients-with-acute-kidney-injury-post-cardiac-surgery-a-meta-analysis
#15
Honghong Zou, Qianwen Hong, Gaosi Xu
BACKGROUND: Acute kidney injury (AKI) is a common clinical complication of cardiac surgery and increases mortality and hospitalization. We aimed to explore and perform an updated meta-analysis of qualitative and quantitative evaluations of the relationship between early renal replacement therapy (RRT) and mortality. METHODS: We searched the Chinese Biomedical Database, the Cochrane Library, EMBASE, Global Health, MEDLINE and PubMed. RESULTS: Fifteen studies (five randomized controlled trials (RCTs), one prospective cohort and nine retrospective cohorts) including 1479 patients were identified for detailed evaluation...
June 17, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28616214/high-dose-hydroxocobalamin-for-vasoplegic-syndrome-causing-false-blood-leak-alarm
#16
Wisit Cheungpasitporn, John Hui, Kianoush B Kashani, Erica D Wittwer, Robert C Albright, John J Dillon
Blood leak alarms are important safety features in a hemodialysis machine to protect patients from loss of blood through a rupture in the dialyzer membrane (true alarms). A false blood leak alarm can be triggered by air bubbles or detector malfunction (such as deposits of grease or scale). Hydroxocobalamin is an injectable form of vitamin B12 approved by the US Food and Drug Administration for the treatment of confirmed or suspected cyanide toxicity. Due to observations of an increase in arterial pressure after high-dose hydroxocobalamin infusion for the treatment of acute cyanide poisoning, it has recently been reported as an off-label rescue treatment for post-cardiopulmonary bypass vasoplegic syndrome...
June 2017: Clinical Kidney Journal
https://www.readbyqxmd.com/read/28580076/postoperative-acute-kidney-injury
#17
REVIEW
Jung Tak Park
Acute kidney injury (AKI) after cardiac surgery is a common and serious complication. Several definitions of AKI have been proposed recently, and include both increases in serum creatinine levels and decreases in urine output as diagnostic criteria. The pathophysiology of postoperative AKI is complex and involves both ischemic injury and systemic inflammation. Identifying risk factors, such as old age, underlying diabetes, heart failure, and obesity, may aid in the application of preventative methods for postoperative AKI...
June 2017: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/28578358/incidence-and-outcome-of-acute-kidney-injury-by-the-prifle-criteria-for-children-receiving-extracorporeal-membrane-oxygenation-after-heart-surgery
#18
Raja Abou Elella, Eiad Habib, Pavla Mokrusova, Princy Joseph, Hani Aldalaty, Mamdouh Al Ahmadi, Zohair Al Halees
BACKGROUND: Acute kidney injury (AKI) is common in patients treated with extracorporeal membrane oxygenation (ECMO). The RIFLE criteria demonstrate clinical relevance for diagnosing AKI and classifying its severity. OBJECTIVES: To systematically define the incidence, clinical course and outcome of AKI using the pediatric pRIFLE criteria. DESIGN: Retrospective, medical records review. SETTINGS: Pediatric cardiac surgical intensive care units at a tertiary care hospital in Riyadh...
May 2017: Annals of Saudi Medicine
https://www.readbyqxmd.com/read/28577069/prevention-of-acute-kidney-injury-and-protection-of-renal-function-in-the-intensive-care-unit-update-2017-expert-opinion-of-the-working-group-on-prevention-aki-section-european-society-of-intensive-care-medicine
#19
M Joannidis, W Druml, L G Forni, A B J Groeneveld, P M Honore, E Hoste, M Ostermann, H M Oudemans-van Straaten, M Schetz
BACKGROUND: Acute kidney injury (AKI) in the intensive care unit is associated with significant mortality and morbidity. OBJECTIVES: To determine and update previous recommendations for the prevention of AKI, specifically the role of fluids, diuretics, inotropes, vasopressors/vasodilators, hormonal and nutritional interventions, sedatives, statins, remote ischaemic preconditioning and care bundles. METHOD: A systematic search of the literature was performed for studies published between 1966 and March 2017 using these potential protective strategies in adult patients at risk of AKI...
June 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28552948/association-of-gain-of-function-ephx2-polymorphism-lys55arg-with-acute-kidney-injury-following-cardiac-surgery
#20
Megan M Shuey, Frederic T Billings, Shouzou Wei, Ginger L Milne, Hui Nian, Chang Yu, Nancy J Brown
Twenty to thirty percent of patients undergoing cardiac surgery develop acute kidney injury (AKI). In mice, inhibition of soluble epoxide hydrolase (sEH) attenuates renal injury following ischemia-reperfusion. We tested the hypothesis that functional variants of EPHX2, encoding sEH, are associated with AKI after cardiac surgery. We genotyped patients in two independent cardiac surgery cohorts for functional EPHX2 polymorphisms, Lys55Arg and Arg287Gln, and determined AKI using Acute Kidney Injury Network criteria...
2017: PloS One
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