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Original scientific paper

A diagnosis of a renal injury by early biomarkers in patients exposed to cardiopulmonary bypass during cardiac surgery

MIRABEL MAŽAR orcid id orcid.org/0000-0002-4589-2490 ; Clinic for Anaesthesiology and Intensive Care, University Hospital Centre Zagreb, Kišpatićeva 12, 10000 Zagreb, Croatia
VIŠNJA IVANČAN ; Clinic for Anaesthesiology and Intensive Care, University Hospital Centre Zagreb, Kišpatićeva 12, 10000 Zagreb, Croatia
IVA ŠEGOTIĆ ; Clinic for Anaesthesiology and Intensive Care, University Hospital Centre Zagreb, Kišpatićeva 12, 10000 Zagreb, Croatia
ŽELJKO ČOLAK ; Clinic for Anaesthesiology and Intensive Care, University Hospital Centre Zagreb, Kišpatićeva 12, 10000 Zagreb, Croatia
RAJKA GABELICA ; Clinic for Anaesthesiology and Intensive Care, University Hospital Centre Zagreb, Kišpatićeva 12, 10000 Zagreb, Croatia
GORDANA RAJSMAN ; Clinic for Anaesthesiology and Intensive Care, University Hospital Centre Zagreb, Kišpatićeva 12, 10000 Zagreb, Croatia
SANDRA UZUN ; Clinic for Anaesthesiology and Intensive Care, University Hospital Centre Zagreb, Kišpatićeva 12, 10000 Zagreb, Croatia
SANJA KONOSIĆ ; Clinic for Anaesthesiology and Intensive Care, University Hospital Centre Zagreb, Kišpatićeva 12, 10000 Zagreb, Croatia
VESNA VEGAR BROZOVIĆ ; Clinic for Anaesthesiology and Intensive Care, University Hospital Centre Zagreb, Kišpatićeva 12, 10000 Zagreb, Croatia
DAVOR STRAPAJEVIĆ ; Clinic for Anaesthesiology and Intensive Care, University Hospital Centre Zagreb, Kišpatićeva 12, 10000 Zagreb, Croatia


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Abstract

We prospectively studied renal function in 158 patients scheduled for elective cardiac surgery with the use of cardiopulmonary
bypass (CPB).
The patients involved in this study had normal renal function as well as normal function of the left ventricle. The results of
the study showed a statistically significant increase of early markers of renal injury Alpha-1-Microglobulin (A1M) and Neutrophil
Gelatinase-Associated Lipocalin (NGAL), which were being traced in the patients’ urine 5 hours and 24 hours after
CPB. In contrast with the aforementioned early markers, the so-called “classical” markers of renal injury – serum urea and
creatinine – did not show a statistical significance of value increase after CPB. Using early factors of renal injury A1M and
NGAL, the study managed to show slight, subclinical injuries of the proximal renal tubules after CPB and cardiac surgeries.
The value of these factors lies in their early and precise detection of renal injury, which is a significant clinical parameter for
monitoring renal function, especially after cardiac surgery with the use of CPB.

Keywords

renal injury; cardiopulmonary bypass; cardiac surgery; markers of tubular renal injury; alpha- 1-microglobulin; neutrophil gelatinase associated lipocalin

Hrčak ID:

134156

URI

https://hrcak.srce.hr/134156

Publication date:

1.6.2014.

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