Acute Kidney Injury after Cardiac Surgery: Risk Factors and Novel Biomarkers

Braz J Cardiovasc Surg. 2019 Jun 1;34(3):352-360. doi: 10.21470/1678-9741-2018-0212.

Abstract

Acute kidney injury (AKI) is a common and severe complication after cardiac surgery. Currently, a series of novel biomarkers have favored the assessment of AKI after cardiac surgery in addition to the conventional indicators. The biomartkers, such as urinary liver fatty acid binding protein (L-FABP), urinary neutrophil gelatinase-associated lipocalin (NGAL), serum L-FABP, heart-type FABP, kidney injury molecule 1 (KIM-1), and interleukin-18 were found to be significantly higher in patients who developed AKI after cardiac surgery than those who did not. Apart from urinary interleukin-18, the novel biomarkers have been recognized as reliable indicators for predicting the diagnosis, adverse outcome, and even mortality of AKI after cardiac surgery. The timing of the renal replacement therapy is a significant predictor relating to patients' prognoses. In patients with AKI after cardiac surgery, renal replacement therapy should be performed as early as possible in order to achieve promising outcomes. In children, AKI after cardiac surgery can be managed with peritoneal dialysis. AKI after cardiac surgery has received extensive attention as it may increase early mortality and impact long-term survival of patients as well. The purpose of this article was to analyze the changes of the pertinent biomarkers, to explore the related risk factors leading to the occurrence of AKI after cardiac surgery, and to provide a basis for the clinical prevention and reduction of AKI.

Keywords: Acute Kidney Injury; Biomarkers; Dialysis; Renal Replacement Therapy; Risk Factors.

Publication types

  • Review

MeSH terms

  • Acute Kidney Injury / etiology*
  • Acute Kidney Injury / therapy
  • Biomarkers / analysis*
  • Cardiac Surgical Procedures / adverse effects*
  • Humans
  • Postoperative Complications / etiology
  • Postoperative Complications / therapy
  • Risk Assessment
  • Risk Factors
  • Time Factors

Substances

  • Biomarkers