Long-Term Consequences of Increased Activity of Urine Enzymes After Cardiac Surgery - A Prospective Observational Study

被引:2
作者
Biernawska, Jowita [1 ]
Kotfis, Katarzyna [2 ,5 ]
Szymanska-Pasternak, Jolanta [3 ]
Bogacka, Anna [4 ]
Bober, Joanna [3 ]
机构
[1] Pomeranian Med Univ, Dept Anesthesiol & Intens Therapy, Szczecin, Poland
[2] Pomeranian Med Univ, Dept Anesthesiol Intens Therapy & Acute Intoxicat, Szczecin, Poland
[3] Pomeranian Med Univ, Dept Med Chem, Szczecin, Poland
[4] West Pomeranian Univ Technol, Dept Commod Sci Qual Assessment Proc Engn & Human, Szczecin, Poland
[5] Pomeranian Med Univ, Dept Anesthesiol Intens Therapy & Acute Intoxicat, PL-70111 Szczecin, Poland
关键词
acute kidney injury; AKI; N-acetyl-beta-glucosaminidase; NAG; arylsulfatase A; ASA; beta-glucuronidase; B-GR; cardiac surgery; ACUTE KIDNEY INJURY; SERUM BIOMARKERS; MORTALITY; ASSAY;
D O I
10.2147/TCRM.S371288
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
Introduction: Cardiac surgery associated AKI (CSA-AKI) complicates recovery and may be associated with a greater risk of developing chronic kidney disease and mortality. The aim of this study was to assess long-term clinical consequences of transient increased activity of urinary enzymes after cardiac surgery (CS).Methods: An observational study was conducted in a group of 88 adult patients undergoing planned coronary artery bypass grafting (CABG), but all samples were obtained from 79 patients. The activity of urinary enzymes: N-acetyl-beta-glucosaminidase (NAG), arylsulfatase A (ASA) and beta-glucuronidase was evaluated in sequential urine samples. A comparative analysis of biochemical parameters was performed regarding the occurrence of acute kidney injury (AKI) defined by KIDGO at 24 hours, at day 30 and 5-years after the operation.Results: During the first 24 hours after CS AKI was diagnosed in 13 patients. A comparison of the activity of urinary enzymes in pre-defined time-points showed significant differences for ASA and NAG (post OP-sample p < 0.028 and p < 0.022; POD 1 sample p < 0.004 and p < 0.001 respectively). No patient had any biochemical or clinical features of kidney failure at day 30. In the AKI group kidney failure was diagnosed in 36% of patients within 5 years of follow-up as opposed to 5% in the no AKI group. The activities of tubular enzymes in urine reflect a general injury of kidney tubules during and after the operation. However, they are not ideal biomarkers for prediction of the degree of kidney injury and further poor prognosis of CS-AKI.
引用
收藏
页码:867 / 877
页数:11
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