Markers warn of progressive kidney problems after heart surgery

March 1, 2012

Blood and urine markers can indicate which patients with an abrupt kidney injury following heart surgery will experience progressive kidney problems, according to a study appearing in an upcoming issue of the Journal of the American Society Nephrology (JASN). Testing for these markers soon after surgery could help doctors protect the health of patients' kidneys.

Acute (AKI), an abrupt or in , is an increasingly prevalent condition. Sometimes AKI arises following heart surgery because the kidneys are deprived of normal blood flow for extended periods of time during the procedure.

In most cases, AKI after heart surgery resolves quickly, but some cases worsen and can seriously affect patients' health and survival. Until now, doctors have not been able to determine which cases of AKI that develop after heart surgery will worsen.

To see if certain markers in the blood and urine might provide some clues, Chirag Parikh, MD, PhD (Yale University School of Medicine), Jay Koyner, MD (University of Chicago, Pritzker School of Medicine), and their colleagues evaluated the blood and urine of 380 patients who developed AKI after .

The investigators found that the presence of certain markers on the day that AKI is diagnosed can indicate structural injury to the kidneys that will likely cause patients to experience progressive problems. High urinary interleukin-18 and a measure called the albumin-to-creatinine ratio increased patients' risk of experiencing persistent AKI by approximately three-fold, while high blood levels of a protein called neutrophil gelatinase-associated lipocalin increased their risk by more than seven-fold.

"Our multi-center study is the largest acute kidney injury biomarker study performed to date in adults, and it strengthens the new paradigm that assessing structural injury at the time of with urine or blood markers of kidney injury can yield important prognostic information," said Dr. Parikh. "Future studies can build on this work and use these markers to enroll patients who are at a high risk for AKI and its associated complications into clinical trials of promising therapies," he added.

More information: The article, entitled "Biomarkers Predict Progression of Acute Kidney Injury following Cardiac Surgery," will appear online on March 1, 2012, doi: 10.1681/ASN.2011090907

Related Stories

Warning signs predict kidney injury after surgery

August 12, 2011

Acute kidney injury (AKI) is a common – but preventable -- complication after surgery that can lead to other complications or even death. The use and development of biomarkers will help physicians diagnose and treat ...

Recommended for you

Experimental MERS vaccine shows promise in animal studies

July 28, 2015

A two-step regimen of experimental vaccines against Middle East respiratory syndrome (MERS) prompted immune responses in mice and rhesus macaques, report National Institutes of Health scientists who designed the vaccines. ...

Can social isolation fuel epidemics?

July 21, 2015

Conventional wisdom has it that the more people stay within their own social groups and avoid others, the less likely it is small disease outbreaks turn into full-blown epidemics. But the conventional wisdom is wrong, according ...

Lack of knowledge on animal disease leaves humans at risk

July 20, 2015

Researchers from the University of Sydney have painted the most detailed picture to date of major infectious diseases shared between wildlife and livestock, and found a huge gap in knowledge about diseases which could spread ...

IBD genetically similar in Europeans and non-Europeans

July 20, 2015

The first genetic study of inflammatory bowel disease (IBD) to include individuals from diverse populations has shown that the regions of the genome underlying the disease are consistent around the world. This study, conducted ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.