Cistatina C e taxa de filtração glomerular em cirurgia cardíaca com circulação extracorpórea

Abstract

Cistatina C e taxa de filtração glomerular em cirurgia cardíaca com circulação extracorpórea Cystatin C and glomerular filtration rate in the cardiac surgery with cardiopulmonary bypass Abstract Objective: The aim of this study was to compare cystatin C versus creatinine as a marker for acute kidney injury in patients submitted to cardiac surgery with cardiopulmonary bypass.Methods: Fifty consecutive patients submitted to coronary artery bypass grafting were studied. Renal function was evaluated by serum cystatin C and creatinine. Blood samples were obtained from each patient at three time points: before operation, and on the first and fifth postoperative days. Glomerular filtration rate (GFR) was calculated by ResumoObjetivo: Avaliar a cistatina C como marcador de função renal em pacientes submetidos à cirurgia de cardíaca com circulação extracorpórea, comparando com a dosagem sérica de creatinina.

Predictors of Postoperative Acute Kidney Injury after Coronary Artery Bypass Graft Surgery

“…The risk of AKI increases 4.8 fold for each 88 µmol/L increment in serum creatinine (SCr) levels [3-5] . AKI severe enough to require renal replacement therapy (RRT) is infrequent, but the operative mortality in these patients ranges from 40% to 80% [6] . This emphasizes the crucial importance of taking any step possible to preserve renal function in the perioperative period, especially in patients at increased risk [3,7-9] .…”

Comparison of serum cystatin C and creatinine changes after cardiopulmonary bypass in patients with normal preoperative kidney function

“…[18-20;28;29] It holds advantages over serum creatinine in that it is unaffected by the demographic characteristics that determine muscle mass and hence serum creatinine level, and its serum levels are also unaffected by tubular secretion. [21;22] Cystatin C has been shown to be a reliable marker of GFR in patients undergoing cardiac surgery, [18][19][20] but its ability to supersede serum creatinine for monitoring changes in GFR in the immediate post-operative period (which is the most important time period for the development of AKI) remains controversial. Some studies have suggested that serum cystatin C may be able to diagnose postoperative AKI more rapidly than serum creatinine, [23] but others have been unable to confirm this.…”

“…[18][19][20] Cystatin C is a 13,25 kDa protein produced by all nucleated cells in the human body. [21] It is freely filtered in the glomerulus, then reabsorbed by epithelial cells in the proximal tubule where it is metabolized and not returned to the systemic circulation.…”

Insuficiência renal oculta acarreta risco elevado de mortalidade após cirurgia de revascularização miocárdica

“…Kidney failure is one of the most important risk factors for complications after both acute ischemic cardiac events [1][2][3][4] and in cardiac surgery, causing longer hospital stays and higher in-hospital mortality [5,6]. In coronary artery bypass grafting (CABG), the previous presence of renal dysfunction is an independent predictor of operative mortality [5.7 to 12].…”