Time trend of ideal biomarker of acute kidney injury in diabetic patients undergoing Coronary Artery Bypass Graft (CABG)

<p>Rasha Shafie</p>

Time trend of ideal biomarker of acute kidney injury in diabetic patients undergoing Coronary Artery Bypass Graft (CABG)

Rasha Shafie

Alexandria University, Egypt

: J Nephrol Ren Dis

Abstract

Abstract: Background: Acute kidney injury (AKI) is an important complication in patients undergoing cardiac surgery. Our study was designed to determine if Tissue Inhibitor Metallo Proteinase (TIMP)-1, 2,3,4 versus Neutrophil gelatinase-associated lipocalin(NGAL )& Procalcitonin can predict AKI early in diabetic CABG patients. Methods: In 40 diabetic patients undergoing coronary artery bypass graft surgery. Serum TIMP-1,2,3,4, NGAL, procalcitonin & serum creatinine were recorded at four time points: at baseline pre-surgery, 4 hours after cardiopulmonary bypass (CPB), 12h post operative and 24h postoperative day. Results: 13 of 40 patients developed AKI. Diagnosis based on AKIN criteria & all patients classified as stage 1. Pre operative Serum TIMP- 1,3,4,NGAL, procalcitonin Mean ± SD respectively were 468.97 ± 297.09, 93.17 ± 40.93, 4.13 ± 2.64, 8.43 ± 2.23, 0.01 ± 0.03 ng/ml continue rising to reach respectively 956.88 ± 519.33, 125.99 ± 29.38, 7.66 ± 1.38, 10.69 ± 1.92, 0.11 ± 0.16 ng/ml at 4h post operative before rising of serum creatinine & TIMP2 which delayed at 12h post operative. Conclusions: Serum TIMP-1,3,4,NGAL & procalcitonin can be used as a predictive test to identify patients at increased risk of AKI very early 4h post CPB before rising of serum creatinine. TIMP-2 increase was delayed 12h post operative as it may not be an early marker in non septic patients. Procalcitonin is not always considered as a marker of sepsis. Most of AKI occurred at 12h post operative. Neither CPB time nor urine output (UOP) has statistical significance in diabetic CABG patients.