New Markers of Cardiac Surgery Related Acute Kidney Injury.

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.

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