New Markers of Cardiac Surgery Related Acute Kidney Injury.

Study Overview
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Brief Summary
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Cardiac surgery related acute kidney injury (CS-AKI) is a clinical problem associated with a cardiopulmonary bypass used during cardiac surgery procedures. In this study the investigators will assess the biochemical markers of acute kidney injury such as ischemia modified albumin (IMA) or urinary excreted of brush-border enzymes of the proximal renal tubules perioperatively. There has been no official recommendations toward routine use of analysed biomarkers.

Detailed Description
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Cardiac surgery related acute kidney injury (CS-AKI) is an important clinical problem. Kidney injury occurs following a cardiopulmonary bypass used during cardiac surgery procedures. The pathomechanisms of acute kidney injury (AKI) is complex and multifactorial. It may involve few injury pathways: ischemia and reperfusion, endogenous toxins, inflammation, metabolic factors and oxidative stress. Biochemical markers of acute kidney injury such as ischemia modified albumin (IMA) or urinary excreted of brush-border enzymes of the proximal renal tubules analysed perioperatively will be assessed in this study. There has been no official recommendations toward routine use of analysed biomarkers.

Official Title
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The New Biochemical Markers of Cardiac Surgery Related Acute Kidney Injury.

Conditions
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Acute Kidney Injury, Cardiac Disease

Intervention / Treatment
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* Diagnostic Test: urine and blood analysis


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: a planned operation of coronary artery bypass grafting with the use of cardiopulmonary bypass Exclusion Criteria: emergency operations or re-operations; a known pathology of the urinary tract or renal failure; chronic use of the following medications: iron, non-steroidal anti-inflammatory drugs (NSAIDs), immunosuppression, or steroids in the preoperative period; polycythemia, porphyria or pathological hemoglobin species in anamnesis; preoperative signs of hepatic failure; active autoimmune or neoplastic diseases, active infection; anticipated significant bleeding (anti-platelet agents), suggesting the use of blood-derived products during the operation and afterward acute myocardial infarction after operation

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| non-AKI<br>patient without acute kidney injury (AKI) during perioperative observation period | Diagnostic Test: urine and blood analysis<br>* concentration of ischemia modified albumin assessed in blood before operation, immediately and one hour after cardiopulmonary bypass, 24 hours after operation; concentration of urinary excretion of brush-border enzymes of the proximal renal tubules assessed before operation, immediately and one hour after cardiopulmonary bypass, 24 hours after operation, serum creatinine levels will be evaluated on the day of the operation and 24 h and 48 h postoperatively<br>|
| AKI<br>patient with diagnosis acute kidney injury (AKI) established during perioperative observation period | Diagnostic Test: urine and blood analysis<br>* concentration of ischemia modified albumin assessed in blood before operation, immediately and one hour after cardiopulmonary bypass, 24 hours after operation; concentration of urinary excretion of brush-border enzymes of the proximal renal tubules assessed before operation, immediately and one hour after cardiopulmonary bypass, 24 hours after operation, serum creatinine levels will be evaluated on the day of the operation and 24 h and 48 h postoperatively<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| acute kidney injure after operation | acute kidney injure measured by creatinine concentration mg/dl | up to 48 hours post operation | 
| acute kidney injure after operation | acute kidney injure measured by urine output in ml | up to 48 hours post operation | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Acute Kidney Injury, cardiopulmonary bypass, brush-border enzymes of the proximal renal tubules, ischemia modified albumin