[Tubular dysfunction after open heart surgery].
beta 2-microglobulin (BMG) and conventional renal function parameters (creatinine clearance (C-cr) etc.) were measured in 36 adult patients before and after open heart surgery (Group-2). Same study was performed in 14 adult patients abdominal surgery (Group-1). Urinary BMG concentration (U-BMG) increased remarkably in both groups immediately after surgery. U-BMG returned to the preoperative level on the 4th postoperative day (4-POD) in Group-1, and 7-POD in Group-2. The degree of increase in Group-2 was remarkable comparing with that in Group-1. The tubular dysfunction after surgery was believed to result in a marked rise in U-BMG, therefore, the later recovery and higher increase of U-BMG in Group-2 indicated that the tubular dysfunction after open heart surgery was severer comparing with that after abdominal surgery. On 7-POD, in Group-2, U-BMG was still abnormal in 13 cases, which suggested the prolonged tubular dysfunction after open heart surgery. A retrospective study to determine the risk factors of prolonged tubular dysfunction was performed in 34 patients in Group-2. Significant risk factors were preoperative blood urea nitrogen and urine osmolarity. Several factors were not significant including perfusion time, aortic alamp time, preoperative C-cr, U-BMG, serum creatinine concentration and free water clearance.
D058186:Acute Kidney Injury / Q000503:physiopathology*; D000293:Adolescent; D000328:Adult; D000368:Aged; D006348:Cardiac Surgical Procedures; D005260:Female; D006331:Heart Diseases / Q000601:surgery; D006801:Humans; D007684:Kidney Tubules / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D001613:beta 2-Microglobulin / Q000652:urine*
D001613:beta 2-Microglobulin