Acute kidney injury after CABG without cardiopulmonary bypass: prediction of outcomes
Abstract
Aim: to analyze changes in kidney function in early postoperation period, 3 months and one year after CABG without cardiopulmonary bypass (CPB) and to estimate the potential of the serum kidney injury molecule I type (KIM-1) and the high-sensitivity С-reactive protein (hsCRP) as the tool for identification which patients would develop worsening of the glomerular filtration rate (eGFR). We studied 141 patients after CABG without CPB. The frequency of acute kidney injury (AKI) and prognostic factors of its development were estimated. We found that the initial high eGFR, female gender and proteinuria are associated with the development of the AKI in this category of patients. In 30 patients, we additionally have evaluated the changes in serum KIM-1 and hsCRP levels before and in the early period after CABG by Elisa test, and the long-term outcome of kidney function. There are evidences that both biomarkers can be used for long-term prognosis.
About the Authors
O. A. Mirolyubova
Northern State Medical University
Russian Federation
Russian Federation
M. A. Alekseeva
E.E. Volosevich First Clinical Hospital, Arkhangelsk
Russian Federation
Russian Federation
A. S. Iakovleva
Northern State Medical University
Russian Federation
Russian Federation
A. N. Shonbin
E.E. Volosevich First Clinical Hospital, Arkhangelsk
Russian Federation
Russian Federation
References
1. Вельков В.В. Цистатин С: новые возможности и новые задачи для лабораторной диагностики. Часть 1 // Клинико-лабораторный консилиум. 2010. № 5 (36). С. 23-31.
2. Вельков В.В. Цистатин С: новые возможности и новые задачи для лабораторной диагностики. Часть 2. // Клинико-лабораторный консилиум. 2011. Т. №1 (37). С. 27-38.
3. Вельков В.В. Цистатин С: новые возможности и новые задачи для лабораторной диагностики. Часть 3 // Клинико-лабораторный консилиум. 2011. № 2. (38). С. 31-37.
4. Плотникова Е.В., Миролюбова О.А., Шонбин А.Н. Факторы риска и отдаленные исходы острого повреждения почек у больных после протезирования клапанов сердца с искусственным кровообращением // Нефрология и диализ. 2011. № 2. С. 96-100.
5. Шонбин А.Н., Заволожин А.С., Быстров Д.О. и др. Кардиохирургическая служба Первой городской клинической больницы им. Е.Е. Волосевич г. Архангельска. Итоги работы за 20-летний период //Кардиоторакальная хирургия: к 100-летию со дня рождения академика Н.М. Амосова: сборник научных трудов / Под ред. С.И. Малявской. Архангельск: Изд-во Северного государственного медицинского университета, 2013. С. 67-73.
6. Che M., Xie B., Xue S. et al. Clinical usefulness of novel biomarkers for the detection of acute kidney injury following elective cardiac surgery // Nephrol. Clinical Practice. 2010. Vol. 115. P. 66-72.
7. Coca S.G., Yusuf B., Shlipak M.G., Garg A.X., Parikh C.R. Long-term risk of mortality and other adverse outcomes after acute kidney injury: A systematic review and meta-analysis // Am. J. Kidney Dis. 2009. Vol. 53. P. 961-973.
8. Eren Z., Ozveren O., Buyukoner E. et al. A Single-centre study of acute cardiorenal syndrome: incidence, risk factors and consequences // Cardiorenal Medicine. 2012. Vol. 2. P. 168-176.
9. Han W.K., Bailly V., Abichandani R. et al. Kidney Injury Molecule-1 (KIM-1): a novel biomarker for human renal proximal tubule injury // Kidney Int. 2002. Vol. 62. №1. P. 237-44.
10. Hobson C.E., Yavas S., Segal M.S.et al. Acute kidney injury is associated with inсreased long-term mortality after cardiothoracic surgery // Circulation. 2009. Vol. 119. P. 2444-2453.
11. Huo W., Zhang K., Nie Z. et al. Kidney injury molecule-1 (KIM-1): a novel kidney-specific injury molecule playing potential double-edged functions in kidney injury // Transplantation Reviews. 2010. Vol. 24. P. 143-146.
12. Ichimura T., Asseldonk E.J., Humphreys B.D. et al. Kidney injury molecule-1 is a phosphatidylserine receptor that confers a phagocytic phenotype on epithelial cells // J. Clin. Invest. 2008. Vol. 118. № 5. P. 1657-1668.
13. Liangos O., Perianayagam M.C., Vaidya V.S. et al. Urinary N-acetyl-beta-(D)-glucosaminidase activity and kidney injury molecule-1 level are associated with adverse outcomes in acute renal failure // J. Am. Soc. Nephrol. 2007. Vol. 18. № 3. P. 904-912.
14. Lovrenčić M.V., Biljak V.R., Božičević S. et al. Estimating glomerular filtration rate (GFR) in diabetes: The performance of MDRD and CKD-EPI equations in patients with various degrees of albuminuria // Annals of Internal Medicine. 2009. Vol. 150. № 9. P.604-612.
15. Maeda I., Hayashi T., Sato K.K. et al. Cigarette smoking and the association with glomerular hyperfiltration and proteinuria in healthy middle-aged men // Clin. J. Am. Soc. Nephrol. 2011. Vol. 6. P. 2462-2469.
16. Massoudy P., Wagner S., Thielmann M., et al. Coronary artery bypass surgery and acute kidney injury - impact of the off-pump technique // Nephrology, Dialysis and Transplantation. 2008. Vol. 23. №9. P. 2853-2860.
17. Melsom T., Mathisen U.D., Ingebretsen O.C. et al. Impaired fasting glucose is associated with renal hyperfiltration in the general population // Diabetes Care. 2011. Vol. 34. №7. P.1546-1551.
18. Nair S., Iqbal K., Phadke M., et al. Effect of cardiopulmonary bypass on tissue injury markers and endothelial activation during coronary artery bypass graft surgery // Journal Postgraduate Medicine. 2012. Vol. 58. №1. P. 8-13.
19. Nigwekar S.U., Kandula P., Hix J.K., et al. Off-pump coronary artery bypass surgery and acute kidney injury: a meta-analysis of randomized and observational studies // American Journal of Kidney Diseases. 2009. Vol. 54. №3. P. 413-423.
20. Okada R., Yasuda Y., Tsushita K. et al. Glomerular hyperfiltration in prediabetes and prehypertension. Nephrol Dial Transplant // 2012. Vol. 27. №5. P.1821-1825.
21. Parikh C.R., Thiessen-Philbrook H., Garg A.X., et al. Performance of kidney injury molecule-1 and liver fatty acid-binding protein and combined biomarkers of AKI after cardiac surgery // Clin. J. Am. Soc. Nephrol. 2013. Vol. 8. №7. P. 1079-88. doi: 10.2215/CJN.10971012. Epub 2013 Apr 18.
22. Parikh C.R., Coca S.G., Thiessen-Philbrook H. et al. Postoperative Biomarkers Predict Acute Kidney Injury and Poor Outcomes after Adult Cardiac Surgery // J. Am. Soc. Nephrol. 2011. Vol. 22. P. 1748-1757. doi: 10.1681/ASN.2010121302.
23. Sauriasari R., Sakano N., Wang D.H. et al. C-reactive protein is associated with cigarette smoking-induced hyperfiltration and proteinuria in an apparently healthy population // Hypertens. Res. 2010. Vol. 33. P. 1129-1136.
24. Sidebotham D. Novel biomarkers for cardiac surgery-associated acute kidney injury: a skeptical assessment of their role // J. Extra Corpor. Technol. 2012. Vol. 44. № 4. P. 235-240.
25. Sprenkle P., Russo P. Molecular markers for ischemia, do we have something better then Creatinine and glomerular filtration rate? // Arch. Esp. Urol. 2013. Vol. 66. №1. P. 99-114.
26. Tsigou E., Psallida V., Demponeras C., et al. Role of new biomarkers: functional and structural damage // Crit. Care Res. Pract. 2013. 2013:361078. doi: 10.1155/2013/361078. Epub 2013 Feb
27. Waanders F., Vaidya V.S., van Goor H. et al. Effect of renin-angiotensin-aldosterone system inhibition, dietary sodium restriction, and/or diuretics on urinary kidney injury molecule 1 exсretion in non-diabetic proteinuric kidney disease: a post hoc analysis of a randomized controlled trial // Am. J. Kidney Dis. 2009. Vol. 53. P. 16-25.
28. Waanders F., van Timmeren M.M., Stegeman C.A. et al. Kidney injury molecule-1 in renal disease // J. Pathol. 2010. Vol. 220. P. 7-16.
29. Wuerzner G., Pruijm M., Maillard M. et al. Marked association between obesity, glomerular hyperfiltration: a сross-sectional study in an African population // Am. J. Kidney Dis. 2010. Vol. 56. P. 303.
30. Zoccali C., Seck S.M., Mallamaci F. Obesity and the epidemiology and prevention of kidney disease: waist circumference versus body mass index //Am. J. Kidney Dis. 2011. Vol. 58. №2. P. 157-159.
Review
For citations:
Mirolyubova O.A., Alekseeva M.A., Iakovleva A.S., Shonbin A.N. Acute kidney injury after CABG without cardiopulmonary bypass: prediction of outcomes. Nephrology and Dialysis. 2014;16(3):350-358. (In Russ.)
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