Changes in serum cystatin C, creatinine, and C‐reactive protein after cardiopulmonary bypass in patients with normal preoperative kidney function

Svensson, Anders S.; Kvitting, John‐Peder Escobar; Kövesdy, Csaba P.; Cederholm, Ingemar; Szabó, Zoltán

doi:10.1111/nep.12630

Cited by 13 publications

(12 citation statements)

References 26 publications

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“…In this study, it was also found that WBC, N% and hs-CRP were transiently increased at T0 and were most significantly increased at T1, which is consistent with the results of a number of experiments (14,15). CRP is an acute-phase reactive protein and an important inflammatory marker, which will obviously increase in the case of acute inflammation and trauma in the body (16).…”

Section: Discussionsupporting

confidence: 92%

Dynamic changes and clinical significance of LXA4 in the perioperative period of cardiopulmonary bypass

Feng

Liao

et al. 2019

Exp Ther Med

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Dynamic changes in lipoxin A4 (LXA4) in child patients with congenital heart disease (CHD), in the perioperative period of cardiopulmonary bypass (CPB) were studied. Peripheral blood was collected from 16 child patients (CPB group) before operation (Tc), after operation (T0), at 1 day after operation (T1), at 3 days after operation (T3), and at 7 days after operation (T7); and from 17 children with no CHD (control group). The level of LXA4 in peripheral blood was detected via enzyme-linked immunosorbent assay (ELISA). Clinical data of the child patients were collected. The white blood cell (WBC) count, the proportion of neutrophils (N%) and high-sensitivity C-reactive protein (hs-CRP) levels were also detected, followed by statistical analysis. The plasma LXA4 levels in CPB group at Tc were significantly lower compared to that in the control group (P<0.01). In CPB group, the level of LXA4 showed an increasing trend at T0, WBC and hs-CRP were transiently increased at T0 and increased most significantly at T1. N% was obviously increased at T0 compared to that at Tc and was still significantly higher at T7 compared to that at Tc. The CPB time and aortic clamping time were positively correlated with the time in the Pediatric Intensive Care Unit (PICU), the application time of ventilator, and the hs-CRP level at T0. The LXA4 level at each time-point had no correlation with other indexes. In conclusion, the inflammatory response after CPB increases the synthesis of LXA4 with an anti-inflammatory effect, but LXA4 cannot be used as a sensitive index for monitoring inflammation.

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Section: Discussionsupporting

confidence: 92%

Dynamic changes and clinical significance of LXA4 in the perioperative period of cardiopulmonary bypass

Feng

Liao

et al. 2019

Exp Ther Med

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“…Cystatin C is an alternative serum measure of kidney function that approximates direct measures of glomerular filtration rate, since it is filtered freely by the renal glomerulus and is less influenced by age, gender, or muscle mass [15,16] . On the other hand, different processes unrelated to kidney function such as acute inflammation may result in a significant increase in serum cystatin C that could erroneously be interpreted as acute kidney injury [17,18] . Whether renal function assessment using cystatin C is superior to creatinine for the detection of CIN, especially in patients with advanced renal dysfunction, remains unclear.…”

Section: Discussionmentioning

confidence: 99%

Ultra-Low Contrast Volume for Patients with Advanced Chronic Kidney Disease Undergoing Coronary Procedures

Rozenbaum

Benchetrit

Rozenbaum

et al. 2018

Nephron

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Background/Aims: Contrast induced nephropathy (CIN) is associated with adverse clinical outcomes in patients undergoing coronary interventions, particularly in patients with advanced chronic kidney. The study was aimed to assess the real-life feasibility and safety of ultra-low volume coronary procedures in patients with advanced chronic kidney disease. Methods: A prospective study that included patients with an estimated glomerular filtration rate (eGFR) <45 mL/min/1.73 m²) was conducted. Coronary procedures were performed using an ultra-low contrast volume technique. Results: The 30 patients had a mean eGFR of 31.8(±8) mL/min/1.73 m². Indications for coronary angiography were non-ST elevation myocardial infarction (63.3%), unstable (20%), and stable angina pectoris (16.7%). Median contrast volume for diagnostic coronary angiography was 13 mL (interquartile ranges [IQR] 12–14.9), and an additional 13 mL (IQR 8.8–14.3) for percutaneous coronary intervention (PCI). In 3 patients (10%), a ≥25% increase was demonstrated in serum cystatin C levels 48 h following the procedure. None of the patients demonstrated a ≥25% increase in serum creatinine levels at 48 h. Following 6 months, no patient required renal replacement therapy or unplanned coronary intervention. Conclusions: In patients with advanced chronic kidney disease, the ultra-low contrast technique is feasible and effective and can be used safely without a significant deterioration in renal function. This technique may increase the utilization of PCI in high-risk coronary patients with chronic kidney disease.

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“…19 Cardiopulmonary bypass per se may elevate cystatin C and C-reactive protein. 20 We recently reported high sensitivity and specificity of intraoperative and postoperative continuous regional renal near-infrared spectroscopy measurement for the development of cardiac surgery-associated renal injury in a prospective cohort of infants. 21 The aim of this study was to determine the association of neutrophil gelatinase-associated lipocalin with the development of acute kidney injury and inflammation in neonates and infants undergoing cardiac surgery.…”

Section: A Cute Kidney Injury Frequently Followsmentioning

confidence: 99%

“…On the other hand, inflammatory markers such as C-reactive protein have been reported to correlate with acute kidney injury incidence and may even play a pathogenic role in the development of kidney failure 19 . Cardiopulmonary bypass per se may elevate cystatin C and C-reactive protein 20 …”

mentioning

confidence: 99%

Neutrophil gelatinase-associated lipocalin reflects inflammation and is not a reliable renal biomarker in neonates and infants after cardiopulmonary bypass: a prospective case–control study

Reiter

Balling²,

Bonelli

et al. 2017

Cardiol Young

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Our results suggest that plasma and urinary neutrophil gelatinase-associated lipocalin values are not reliable indicators of impending acute kidney injury in neonates and infants after cardiac surgery with cardiopulmonary bypass. Inflammation may have a major impact on plasma neutrophil gelatinase-associated lipocalin values in infant cardiac surgery. Urinary neutrophil gelatinase-associated lipocalin may add little prognostic value over cardiopulmonary bypass time.

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Changes in serum cystatin C, creatinine, and C‐reactive protein after cardiopulmonary bypass in patients with normal preoperative kidney function

Cited by 13 publications

References 26 publications

Dynamic changes and clinical significance of LXA4 in the perioperative period of cardiopulmonary bypass

Dynamic changes and clinical significance of LXA4 in the perioperative period of cardiopulmonary bypass

Ultra-Low Contrast Volume for Patients with Advanced Chronic Kidney Disease Undergoing Coronary Procedures

Neutrophil gelatinase-associated lipocalin reflects inflammation and is not a reliable renal biomarker in neonates and infants after cardiopulmonary bypass: a prospective case–control study

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