Value of Preoperative Creatine Kinase-MB for Prediction of Acute Kidney Injury in Congenital Cardiac Surgery Using Cardiopulmonary Bypass: a prospective study

Abstract

Background: Acute kidney injury (AKI) is a common complication associated with cardiac surgery with cardiopulmonary bypass (CPB) with a deleterious effect on morbidity and mortality. The current study aimed to determine the efficacy of preoperative creatine kinase-MB (CK-MB) level for the prediction of occurrence and severity of AKI. Settings and Design: This study was a prospective cross-sectional observational study. Methods: The study was carried out on 74 pediatric patients aged less than 18 years scheduled for elective congenital cardiac surgery using CPB. The prevalence of AKI within 72 hours was defined according to the three-stage Acute Kidney Injury Network (AKIN) criteria. Logistic regression analysis was done and adjusted odds ratio (OR) and confidence intervals at 95% (95% CI) were calculated. Results: AKI had developed in 25 patients (33.78%) by the second postoperative day. Patients who developed AKI had higher mean levels of preoperative CK-MB compared with patients without AKI (P = 0.002). Lower mean age, longer duration of surgery, bypass time, and crossclamp time were independently associated with AKI (p < 0.015, 0.001, 0.001and 0.001, respectively). Patients who developed AKI had a longer duration of mechanical ventilation (MV) (OR 1.3, 95% CI 1.147-1.691) so; they required longer intensive care unit (ICU) stay. Conclusion: CK-MB can be a useful biomarker for detecting early AKI after congenital cardiac surgery and predicting adverse clinical outcomes.