title: Renal effects of coronary artery bypass graft surgery in diabetic and non-diabetic patients: a study with urinary neutrophil gelatinase-associated lipocalin and serum cystatin C.
abstract: OBJECTIVE
  Cardiac surgery and diabetes are major causes of acute kidney injury (AKI). We aimed to investigate the value of urinary neutrophil gelatinase-associated lipocalin (NGAL) and serum cystatin C, as early biomarkers for prediction of AKI in diabetic and non-diabetic adult patients undergoing cardiac surgery.
  
  
  METHODS
  15 non-diabetic and 15 diabetic adult patients undergoing cardiac surgery were enrolled. Peri-operative clinical and laboratory variables were recorded. Urinary NGAL, serum cystatin C, serum creatinine (Cre) and blood urea nitrogen (BUN) were evaluated.
  
  
  RESULTS
  AKI was detected in 4 patients in non-diabetic group and 12 patients in diabetic group. Urinary NGAL levels of diabetic and non-diabetic patients and serum cystatin C levels of diabetic patients exceed upper normal limits or cutoff values much earlier than BUN and Cre. cystatin C levels of non-diabetic patients remain unchanged. Cystatin C and NGAL levels of patients meeting AKI criteria and NGAL levels of patients not meeting AKI criteria exceeded upper normal limits or cut off values much earlier in than BUN and Cre.
  
  
  CONCLUSIONS
  Measurement of cystatin C level in both diabetic and non-diabetic patients may reveal AKI earlier than NGAL and BUN. In diabetic patients, measurement of urinary NGAL and serum cystatin C levels may indicate AKI signs earlier than BUN and Cre.
authors.affiliation: Department of Anesthesiology and Reanimation, Selcuk University, Faculty of Medicine, Selcuklu Konya, Turkey.
authors.forename: Oguzhan
authors.initials: O
authors.lastname: Arun
authors.forename: Gulperi
authors.initials: G
authors.lastname: Celik
authors.forename: Bahar
authors.initials: B
authors.lastname: Oc
authors.forename: Ali
authors.initials: A
authors.lastname: Unlu
authors.forename: Jale Bengi
authors.initials: JB
authors.lastname: Celik
authors.forename: Mehmet
authors.initials: M
authors.lastname: Oc
authors.forename: Ates
authors.initials: A
authors.lastname: Duman
mesh_terms: D058186:Acute Kidney Injury / Q000453:epidemiology / Q000209:etiology*; D000209:Acute-Phase Proteins / Q000652:urine*; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers; D001806:Blood Urea Nitrogen; D001026:Coronary Artery Bypass / Q000009:adverse effects*; D003404:Creatinine / Q000097:blood; D055316:Cystatin C / Q000652:urine*; D048909:Diabetes Complications / Q000378:metabolism*; D005260:Female; D006801:Humans; D007677:Kidney Function Tests; D000071068:Lipocalin-2; D054834:Lipocalins / Q000652:urine*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011518:Proto-Oncogene Proteins / Q000652:urine*; D016896:Treatment Outcome; D014563:Urodynamics
chemical_list: D000209:Acute-Phase Proteins; D015415:Biomarkers; D055316:Cystatin C; C489506:LCN2 protein, human; D000071068:Lipocalin-2; D054834:Lipocalins; D011518:Proto-Oncogene Proteins; D003404:Creatinine