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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 Cardiorenal+Med
2016 ; 6
(3
): 216-29
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English Wikipedia
Risk Factors for Acute Kidney Injury after Coronary Artery Bypass Surgery and Its
Detection Using Neutrophil Gelatinase-Associated Lipocalin
#MMPMID27275158
Onk OA
; Onk D
; Ozcelik F
; Gunay M
; Turkmen K
Cardiorenal Med
2016[May]; 6
(3
): 216-29
PMID27275158
show ga
INTRODUCTION: Acute kidney injury (AKI) is an important complication of cardiac
surgery due to its high mortality. The aim of the present study was to detect the
factors leading to AKI in patients who underwent coronary artery bypass surgery
(CABS) and also to determine the optimal timing for detecting AKI using the
biomarker neutrophil gelatinase-associated lipocalin (NGAL). MATERIALS AND
METHODS: The records of 375 patients who underwent CABS were reviewed in this
case-control study. Ejection fraction (EF), common carotid artery intima-media
thickness (CCA-IMT) and cross-clamp (C-C) time of the patients were recorded.
Blood samples were taken from all patients on preoperative day 1 as well as 6,
12, 24, 36, 48 h and 7 days after operation. Biochemical parameters were studied
in patients with and without AKI. RESULTS: According to the Risk Injury Failure
Loss End Stage criteria, 24 patients had renal risk, 17 had injury and 4 had
failure. Postoperative 24-hour serum creatinine levels indicated the risk of
renal dysfunction for only 4 patients in the AKI group. CCA-IMT, C-C time,
haematocrit (HCT) and preoperative interleukin-6 levels were significantly higher
in the AKI group than in the non-AKI group. Postoperative 6- and 12-hour NGAL
levels in the AKI group correlated with postoperative 36-hour serum creatinine
levels. The optimal cut-off values for postoperative 6- and 12-hour NGAL test
were 310 and 283 ng/ml, respectively. The area under the curve was higher in the
12-hour NGAL test (p < 0.0086). CONCLUSION: The number of stenotic coronary
arteries, EF, CCA-IMT and HCT are all important risk factors. Early postoperative
NGAL results were highly specific for the early recognition of AKI.