New Markers of Cardiac Surgery Related Acute Kidney Injury.

The New Biochemical Markers of Cardiac Surgery Related Acute Kidney Injury.

Cardiac surgery related acute kidney injury (CS-AKI) is a clinical problem associated with a cardiopulmonary bypass used during cardiac surgery procedures. In this study the investigators will assess the biochemical markers of acute kidney injury such as ischemia modified albumin (IMA) or urinary excreted of brush-border enzymes of the proximal renal tubules perioperatively. There has been no official recommendations toward routine use of analysed biomarkers.

Cardiac surgery related acute kidney injury (CS-AKI) is an important clinical problem. Kidney injury occurs following a cardiopulmonary bypass used during cardiac surgery procedures. The pathomechanisms of acute kidney injury (AKI) is complex and multifactorial. It may involve few injury pathways: ischemia and reperfusion, endogenous toxins, inflammation, metabolic factors and oxidative stress. Biochemical markers of acute kidney injury such as ischemia modified albumin (IMA) or urinary excreted of brush-border enzymes of the proximal renal tubules analysed perioperatively will be assessed in this study. There has been no official recommendations toward routine use of analysed biomarkers.

Inclusion Criteria:

• a planned operation of coronary artery bypass grafting with the use of cardiopulmonary bypass

Exclusion Criteria:

• emergency operations or re-operations;
• a known pathology of the urinary tract or renal failure;
• chronic use of the following medications: iron, non-steroidal anti-inflammatory drugs (NSAIDs), immunosuppression, or steroids in the preoperative period;
• polycythemia, porphyria or pathological hemoglobin species in anamnesis;
• preoperative signs of hepatic failure;
• active autoimmune or neoplastic diseases, active infection;
• anticipated significant bleeding (anti-platelet agents), suggesting the use of blood-derived products during the operation and afterward
• acute myocardial infarction after operation