title: Role of renal biomarkers as predictors of acute kidney injury in cardiac surgery.
abstract: Cardiac surgery is unique in using cardiopulmonary bypass in various clinical scenarios. Injury of vital organs is unavoidable in the perioperative period. Acute kidney injury is a consequence of the systemic inflammatory response after bypass, emboli, ischemia, and low cardiac output states, reportedly occurring in 30%-40% of open heart surgeries. Acute kidney injury is associated with increased morbidity, mortality, and cost. Many preventive measures (off-pump procedures, decreased crossclamp time, pulsatile flow, adequate hydration) are taken in the perioperative period to avoid organ injury, but in vain. Traditionally, blood urea, serum creatinine, and creatinine clearance rate were applied for prediction of acute kidney injury. The recent emergence of biomarkers such as neutrophil gelatinase-associated lipocalin, cystatin C, liver-type fatty acid binding protein, interleukin-18, kidney injury molecule-1, and tetrahydrobiopterin have helped in detecting acute kidney injury long before the rise of serum creatinine. These biomarkers can also be used as tools for predicting therapeutic effects in acute kidney injury and for monitoring drug toxicity. This review consolidates the knowledge of biomarkers and their application in acute kidney injury management.
authors.affiliation: Department of Cardiothoracic and Vascular Surgery, SSKM Hospital and IPGME&R Kolkata, India.
authors.forename: Ravi
authors.initials: R
authors.lastname: Ghatanatti
authors.forename: Anita
authors.initials: A
authors.lastname: Teli
authors.forename: Sundeep Sanjivan
authors.initials: SS
authors.lastname: Tirkey
authors.forename: Subhankar
authors.initials: S
authors.lastname: Bhattacharya
authors.forename: Gautam
authors.initials: G
authors.lastname: Sengupta
authors.forename: Ansuman
authors.initials: A
authors.lastname: Mondal
mesh_terms: D058186:Acute Kidney Injury / Q000097:blood* / Q000175:diagnosis / Q000209:etiology / Q000628:therapy / Q000652:urine*; D015415:Biomarkers / Q000097:blood / Q000652:urine; D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D042241:Early Diagnosis; D006801:Humans; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers
keywords: acute kidney injury; biological markers; cardiac surgical procedures; postoperative complications; predictive value of tests