TY  - JOUR
A1  - Magyar, Attila
A1  - Wagner, Martin
A1  - Thomas, Phillip
A1  - Malsch, Carolin
A1  - Schneider, Reinhard
A1  - Störk, Stefan
A1  - Heuschmann, Peter U
A1  - Leyh, Rainer G
A1  - Oezkur, Mehmet
T1  - HO-1 concentrations 24 hours after cardiac surgery are associated with the incidence of acute kidney injury: a prospective cohort study
JF  - International Journal of Nephrology and Renovascular Disease
N2  - Background: 
Acute kidney injury (AKI) is a serious complication after cardiac surgery that is associated with increased mortality and morbidity. Heme oxygenase-1 (HO-1) is an enzyme synthesized in renal tubular cells as one of the most intense responses to oxidant stress linked with protective, anti-inflammatory properties. Yet, it is unknown if serum HO-1 induction following cardiac surgical procedure involving cardiopulmonary bypass (CPB) is associated with incidence and severity of AKI.

Patients and methods: 
In the present study, we used data from a prospective cohort study of 150 adult cardiac surgical patients. HO-1 measurements were performed before, immediately after and 24 hours post-CPB. In univariate and multivariate analyses, the association between HO-1 and AKI was investigated.

Results: 
AKI with an incidence of 23.3% (35 patients) was not associated with an early elevation of HO-1 after CPB in all patients (P=0.88), whereas patients suffering from AKI developed a second burst of HO-1 24 hours after CBP. In patients without AKI, the HO-1 concentrations dropped to baseline values (P=0.031). Furthermore, early HO-1 induction was associated with CPB time (P=0.046), while the ones 24 hours later lost this association (P=0.219).

Conclusion: 
The association of the second HO-1 burst 24 hours after CBP might help to distinguish between the causality of AKI in patients undergoing CBP, thus helping to adapt patient stratification and management.
KW  - acute kidney injury
KW  - cardiac surgery
KW  - heme oxygenase-1
KW  - cardiopulmonary bypass
Y1  - 2019
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-177250
VL  - 12
ER  -