Preoperative Iron Profile Disarrangements, Could It Predict Cardiac Surgery-Associated Acute Kidney Injury (CSA-AKI)? | ||||
| The Egyptian Journal of Hospital Medicine | ||||
| Article 12, Volume 100, Issue 1, July 2025, Page 2610-2614 PDF (517.13 K) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/ejhm.2025.436678 | ||||
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| Abstract | ||||
| Background: One of the well-known mechanisms of acute kidney injury after heart surgery is ferroptosis, or iron-dependent nonapoptotic controlled cell death, which is frequently linked to deranged serum iron and its binding proteins. Objective: The purpose of this study was to determine how well preoperative biomarkers of basic iron metabolism could predict cardiac surgery-associated acute kidney injury (CSA-AKI). Patients and Methods: Over the course of three years, from January 2022 to February 2025, we recruited 350 patients who underwent open heart procedures at Kasr-Alainy, Ain Shams, and Fayoum University hospitals. After that, we divided the patients based on the incidence of CSA-AKI, as defined by the Kidney Disease Improving Global Outcomes (KDIGO) guidelines, into two groups: Group A, referred to as the no-AKI group, and Group B, referred to as the AKI group. We then reviewed their preoperative data on serum iron (SI), ferritin, transferrin (TRF), and total iron binding capacity (TIBC), as well as their postoperative requirements for renal dialysis, hospitalization, and early mortality. Results: In the initial 48 hours following surgery, 133 out of 350 patients experienced acute kidney injury (AKI). Among those with AKI, there were significantly higher levels of preoperative serum ferritin (234.49 + 135.53 vs. 184.32 + 90.93, P < 0.0001) and TIBC (37.7 + 8.6 vs. 35.3 + 7.2, P value = 0.0075). While preoperative serum iron and transferrin levels, as well as the counts of early fatalities and patients requiring prolonged mechanical ventilation, ICU, and hospital stays, were also elevated in this group, but the differences were not statistically significant (P value > 0.05%). Conclusion: A higher risk of CSA-AKI has been associated with increased basic iron metabolism indices, especially when preoperative levels of ferritin and TIBC are elevated. | ||||
| Keywords | ||||
| Preoperative ferritin; TIBC; Cardiac surgery and AKI | ||||
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