Acute Renal Dysfunction After Cardiac Surgery: Predictors, Mechanisms of Development and Criteria for Diagnosis
Abstract
This publication describes severe complication after cardiac surgery – acute renal failure; the current literature on the development of acute renal failure after cardiac surgery. In publication report reason of acute renal failure, the criteria for diagnosis are viewed. The criteria for diagnosis are discussed, taking into account the specifi cs of kidney damage after cardiopulmonary bypass or a long period of ischemia. The article describes methods of reducing kidney damage during cardiac arrest during thoracoabdominal aorta surgery. The information is presented in terms of the clinician, they can be applied in everyday practice of the surgeon. Accounting data presented will reduce the incidence of this complication.
About the Authors
Yu. V. Belov
Federal State Scientifi c Institution «Russian Scientifi c Center of Surgery
named after academician B.V. Petrovsky»
Russian Federation
Russian Federation
MD, academician of RAS, prof., director
P. F. Litvitsky
I.M. Sechenov First MSMU
Russian Federation
Russian Federation
Petr Frantsevich Litvitsky, MD, prof., corresp. member of RAS, head of the chair of pathophysiology
8/2 Trubetskaya str., Moscow, 119991
8 (985) 769–07–38
I. A. Vinokurov
I.M. Sechenov First MSMU
Russian Federation
Russian Federation
PhD, physician, cardiovascular surgeon, associate researcher of the Educational and Clinical Center of aorta and invasive cardiology
References
1. Kork F., Balzer F., Spies C.D. et al. Minor postoperative Increases of Creatinine Are associated with higher mortality and longer hospital length of stay in surgical patients // Anesthesiology. 2015. 22: 33-38.
2. Hoste E.A., Cruz D.N., Davenport A. et al. The epidemiology of cardiac surgery-associated acute kidney injury // Int. J. Artif. Organs. 2008; 31: 158-165.
3. Hu J., Chen R., Liu S. et al. Global incidence and outcomes of adult patients with acute kidney injury after cardiac surgery: A systematic review and meta-analysis // J. Cardiothorac. Vasc. Anesth. 2015, Jun. 10. pii: S1053- 0770(15)00567-4.
4. Tian J., Barrantes F., Amoateng-Adjepong Y. et al. Rapid reversal of acute kidney injury and hospital outcomes: A retrospective cohort study // Am. J. Kidney Dis. 2009; 53: 974-981.
5. Mehta R.H., Grab J.D., O'Brien S.M. et al. Bedside tool for predicting the risk of postoperative dialysis in patients undergoing cardiac surgery // Circulation. 2006; 114: 2208- 2216.
6. Wij eysundera D.N., Karkouti K., Dupuis J.Y. et al. Derivation and validation of a simplifi ed predictive index for renal replacement therapy after cardiac surgery // JAMA. 2007; 297: 1801-1809.
7. Jones D.R., Lee H.T. Perioperative renal protection // Best Pract. Res. Clin. Anaesthesiol. 2008, Mar; 22(1): 193-208.
8. Del Duca D., Iqbal S., Rahme E., de Varennes B. Renal failure after cardiac surgery: Timing of cardiac catheterization and other perioperative risk factors // Ann. Thorac. Surg. 2007; 84: 1264–1267.
9. Kincaid E.H., Ashburn D.A., Hoyle J.R. et al. Does the combination of aprotinin and angiotensin-converting enzyme inhibitor cause renal failure after cardiac surgery? // Ann. Thorac. Surg. 2005; 80: 1388–1393.
10. Mao H., Katz N., Ariyanon W. et al. Cardiac surgery-associated acute kidney injury // Blood Purif. 2014; 37 Suppl. 2: 34-50.
11. Vercaemst L. Hemolysis in cardiac surgery patients undergoing cardiopulmonary bypass: A review in search of a treatment algorithm // J. Extracorp. Thecnol. 2008; 40: 257–267.
12. Goligorsky M.S. Whispers and shouts in the pathogenesis of acute renal ischaemia // Nephrol. Dial. Transplant. 2005; 20: 261-266.
13. Haase M., Haase-Fielitz A., Bellomo R. Cardiopulmonary bypass, hemolysis, free iron, acute kidney injury and the impact of bicarbonate // Contrib. Nephrol. 2010; 165: 28- 32. doi: 10.1159/000313741.
14. Бадаев С.В., Томилина М.А., Борисовская С.В. и др. Ремоделирование миокарда при прогрессирующей хронической недостаточности в исходе недиабетических нефропатий // Нефрол. и диализ. 2005; 3: 321-328. [Badaev S.V., Tomilina M.A., Borisovskaya S.V. et al. Remodeling progressive chronic myocardial insuffi ciency in the outcome of diabetic nephropathy // Nefrol. i dializ. 2005; 3: 321-328.]
15. Решетников Е.А., Чуванов М.Б., Денисов А.Ю. и др. Экстракорпоральная детоксикация в комплексном лечении хирургического сепсиса // Хирургия. 2001; 1: 71-72. [Reshetnikov E.A., Chuvanov M.B., Denisov A.Yu. et al. Extracorporeal detoxifi cation in treatment of surgical sepsis // Khirurgiya. 2001; 1: 71-72.]
16. Garwood S. Cardiac surgery-associated acute renal injury: New paradigms and innovative therapies // J. Cardiothorac. Vasc. Anesth. 2010; 24: 990-1001.
17. Vermeulen Windsant I.C., de Wit N.C., Sertorio J.T. et al. Hemolysis during cardiac surgery is associated with increased intravascular nitric oxide consumption and perioperative kidney and intestinal tissue damage // Front. Physiol. 2014, Sep. 8; 5: 340.
18. Maringer K., Sims-Lucas S. The multifaceted role of the renal microvasculature during acute kidney injury // Pediatr. Nephrol. 2015, Oct. 22.
19. O'Brien M.M., Gonzales R., Shroyer A.L. et al. Modest serum creatinine elevation aff ects adverse outcome after general surgery // Kidney Int. 2002; 62: 585–592.
20. Karkouti K., Wij eysundera D.N., Yau T.M. et al. Acute kidney injury after cardiac surgery: Focus on modifi able risk factors // Circulation. 2009; 119: 495–502.
21. Perez-Valdivieso J.R., Monedero P., Vives M. et al. Cardiac-surgery associated acute kidney injury requiring renal replacement therapy. A Spanish retrospective casecohort study // Nephrol. 2009; 10: 27.
22. Ferraris V.A., Ferraris S.P., Saha S.P. et al. Perioperative blood transfusion and blood conservation in cardiac surgery: The Society of Thoracic Surgeons and The Society of Cardiovascular Anesthesiologists clinical practice guideline // Ann. Thorac. Surg. 2007; 83: 27–86.
23. Birnie K., Verheyden V., Pagano D. et al. Predictive models for kidney disease: Improving global outcomes (KDIGO) defi ned acute kidney injury in UK cardiac surgery // Crit. Care. 2014, Nov. 20; 18(6): 606.
24. Thakar C.V., Arrigain S., Worley S. et al. A clinical score to predict acute renal failure after cardiac surgery // J. Am. Soc. Nephrol. 2005; 16: 162–168.
25. Kumar A.B., Suneja M. Cardiopulmonary bypass-associated acute kidney injury // Anesthesiology. 2011; 114: 964-970.
26. Karkouti K., Wij eysundera D.N., Yau T.M. et al. Infl uence of erythrocyte transfusion on the risk of acute kidney injury after cardiac surgery diff ers in anemic and nonanemic patients // Anesthesiology. 2011; 115: 523–530.
27. Karkouti K., Wij eysundera D.N., Yau T.M. et al. Advance targeted transfusion in anemic cardiac surgical patients for kidney protection: An unblended randomized pilot clinical trial // Anesthesiology. 2012; 116: 613–621.
28. Huybregts R.A., de Vroege R., Jansen E.K. et al. The association of hemodilution and transfusion of red blood cells with biochemical markers of splanchnic and renal injury during cardiopulmonary bypass // Anesth. Analg. 2009; 109: 331–339.
29. Ho J., Lucy M., Krokhin O. et al. Mass spectrometry-based proteomic analysis of urine in acute kidney injury following cardiopulmonary bypass: A nested case–control study // Am. J. Kidney Dis. 2009; 53: 584-595.
30. Redfors B., Bragadottir G., Sellgren J. et al. Acute renal failure is NOT an ‘acute renal success’ – a clinical study on the renal oxygen supply / demand relationship in acute kidney injury // Crit. Care Med. 2010; 38: 1695– 1701.
31. Almac E., Ince C. The impact of storage on red cell function in blood transfusion // Best Pract. Res. Clin. Anaesthesiol. 2007; 21: 195–208.
32. Leaf D.E., Rajapurkar M., Lele S.S. et al. Plasma catalytic iron, AKI, and death among critically ill patients // Clin. J. Am. Soc. Nephrol. 2014, Nov. 7; 9(11): 1849-1856.
33. Tinmouth A., Fergusson D., Yee I.C. et al. Clinical consequences of red cell storage in the critically ill // Transfusion. 2006; 46: 2014–2027.
34. Donadee C., Raat N.J., Kanias T. et al. Nitric oxide scavenging by red blood cell microparticles and cell-free hemoglobin as a mechanism for the red cell storage lesion // Circulation. 2011; 124: 465–476.
35. Lasocki S., Longrois D., Montravers P., Beaumont C. Hepcidin and anemia of the critically ill patient: Bench to bedside // Anesthesiology. 2011; 114: 688–694.
36. Vermeulen Windsant I.C., Hanssen S.J., Buurman W.A., Jocobs M.J. Cardiovascular surgery and organ damage: Time to reconsider the role of hemolysis // J. Thorac. Cardiovasc. Surg. 2011; 142: 1–11.
37. Haase M., Bellomo R., Haase-Fielitz A. Novel biomarkers, oxidative stress, and the role of labile iron toxicity in cardiopulmonary bypass-associated acute kidney injury // J. Am. Coll. Cardiol. 2010; 55: 2024-2033.
38. Watanabe G., Ohtake H., Tomita S. et al. Tepid hypothermic (32°C) circulatory arrest for total aortic arch replacement: a paradigm shift from profound hypothermic surgery // Interactive Cardiovascular and Thoracic Surgery. 2011; 12: 952-955.
39. Pacini D., Pantaleo A., Di Marco L. et al. Visceral organ protection in aortic arch surgery: Safety of moderate hypothermia // Eur. J. Cardiothorac. Surg. 2014, Sep.; 46(3): 438-443.
40. Yang S.S., Park K.M., Roh Y.N. et al. Renal and abdominal visceral complications after open aortic surgery requiring supra-renal aortic cross clamping // J. Korean Surg. Soc. 2012; 83: 162-170.
41. Wahlberg E., Dimuzio P.J., Stoney R.J. Aortic clamping during elective operations for infrarenal disease: The infl uence of clamping time on renal function // J. Vasc. Surg. 2002; 36: 13–18.
42. Бокерия Л.А., Шаталов К.В., Свободов А.А. Системы вспомогательного и заместительного кровообращения. М. Изд. НЦССХ им. А.Н. Бакулева РАМН. 2000: 196 с. [Bokeriya L.A., Shatalov K.V., Svobodov A.A. Auxiliary systems and substitution of circulation. M. SCHS named after A.N. Bakulev RAMS. 2000: 196 p.]
43. Белов Ю.В., Комаров Р.Н. Руководство по хирургии торакоабдоминальных аневризм аорты. М. МИА. 2009: 464 с. [Belov Yu.V., Komarov R.N. Guidelines for thoracoabdominal aortic aneurysm surgery. M. MIA. 2009: 464 p.]
44. Regner K.R., Roman R.J. Role of medullary blood fl ow in the pathogenesis of renal ischemia-reperfusion injury // Curr. Opin. Nephrol. Hypertens. 2012; 21: 33-38.
45. Harvey R.B. Eff ects of temperature on function of isolated dog kidney // Amer. J. Physiol. 1959; 197: 181–186.
46. Semb G., Krog J., Johansen K. Renal metabolism and blood fl ow during local hypothermia, studied by means of renal perfusion in situ // Acta Chir. Scand. Suppl. 1960; 253: 196–202.
47. Köksoy C., LeMaire S.A., Curling P.E. et al. Renal perfusion during thoracoabdominal aortic operations: Cold crystalloid is superior to normothermic blood // Ann. Thorac. Surg. 2002; 73: 730–738.
48. Lemaire S.A., Jones M.M., Conklin L.D. et al. Randomized comparison of cold blood and cold crystalloid renal perfusion for renal protection during thoracoabdominal aortic aneurysm repair // J. Vasc. Surg. 2009; 49: 11–19.
49. Белов Ю.В., Комаров Р.Н., Гулешов В.А. Патент на изобретение № 2343856. Способ защиты висцеральных органов при хирургическом лечении торакоабдоминальных аневризм аорты. Приоритет изобретения от 15.05.2007 г. Зарегистрировано в Государственном реестре изобретений РФ 20.01.2009. [Belov Yu.V., Komarov R.N., Guleshov V.A. The patent for the invention № 2343856. The method of protection of visceral organs in the surgical treatment of thoracoabdominal aortic aneurysms. The priority of invention from 15.05.2007 Registered in the State Register of Inventions of the Russian Federation 20.01.2009.]
50. Белов Ю.В., Комаров Р.Н., Степаненко А.Б. и др. Способ защиты висцеральных органов в хирургии торакоабдоминальной аорты: Сборник тезисов уральской региональной научно-практической конференции «Современные возможности лечения заболеваний сердца и сосудов», Екатеринбург, 13–14 декабря 2007; Екатеринбург: Уральский центр академического обслуживания: 11–12. [Belov Yu.V., Komarov R.N., St abdominal aortic surgery: Abstracts of the Ural regional scientifi c-practical conference «Current treatment options for diseases of the heart and blood vessels», Ekaterinburg, 13-14 December 2007; Ekaterinburg: Ural Academic Service Center: 11-12.]
51. Tshomba Y., Kahlberg A., Melissano G. et al. Comparison of renal perfusion solutions during thoracoabdominal aortic aneurysm repair // J. Vasc. Surg. 2013: S0741- 5214(13)01798-1799.
52. Kudo F.A., Nishibe T., Miyazaki K. et al. Postoperative renal function after elective abdominal aortic aneurysm repair requiring suprarenal aortic cross-clamping // Surg. Today. 2004; 34: 1010–1013.
53. Bellomo R., Ronco C., Kellum J.A. et al. Acute Dialysis Quality Initiative Group. Acute renal failure–defi nition, outcome measures, animal models, fl uid therapy and information technology needs: the Second International Consensus Conference of the Acute Dialysis Quality Initiative (ADQI) Group // Crit. Care. 2004; 8: 204–212.
54. Mehta R.L., Kellum J.A., Shah S.V. et al. Acute kidney injury network: Report of an initiative to improve outcomes in acute kidney injury // Crit. Care. 2007; 11: 31.
55. Englberger L., Suri R.M., Li Z. et al. Clinical accuracy of RIFLE and Acute Kidney Injury Network (AKIN) criteria for acute kidney injury in patients undergoing cardiac surgery // Critical Care. 2011; 15(1): 16.
56. Englberger L., Suri R.M., Schaff H.V. RIFLE is not RIFLE: On the comparability of results // Crit. Care. 2009; 13: 429.
57. Белов Ю.В., Катков А.И., Винокуров И.А. Риски и возможности профилактики развития острой почечной недостаточности у пациентов после операции на сердце // Кардиология и сердечно-сосудистая хирургия. 2015; 3: 18-23. [Belov Yu.V., Katkov A.I., Vinokurov I.A. Risks and possible prevention of acute renal failure in patients following heart surgery // Kardiologiya i serdechno-sosudistaya khirurgiya. 2015; 3: 18-23.
Review
Views: 9
Email this article 