Time To Think of Novel Biomarkers to Detect Perioperative Acute Kidney Injury in Surgical Patients

Singh, Sanjeev; Okyere, Isaac; Singh, Arti; Shaifulla, Pavagada; Okyere, Perditer; Boamah, Richmond Adu Boahen

doi:10.21608/eajbsc.2022.226918

	Time To Think of Novel Biomarkers to Detect Perioperative Acute Kidney Injury in Surgical Patients
Egyptian Academic Journal of Biological Sciences. C, Physiology and Molecular Biology
Article 19, Volume 14, Issue 1, June 2022, Page 213-229 PDF (782.46 K)
Document Type: Original Article
DOI: 10.21608/eajbsc.2022.226918
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Authors
Sanjeev Singh¹; Isaac Okyere²; Arti Singh³; Pavagada Shaifulla⁴; Perditer Okyere²; Richmond Adu Boahen Boamah²
¹School of Medicine and Dentistry, CHS, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana -Directorate of Anaesthesia and Intensive Care, Komfo Anokye Teaching Hospital, Kumasi, Ghana
²School of Medicine and Dentistry, CHS, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
³School of Public health, CHS, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
⁴Department of Medicine, Viswabhatathi Medical College, Kurnool, India
Abstract
Background: Perioperative (peri-op) acute kidney injury is impairment of normal baseline renal function during surgery or the immediate postoperative (post-op) period. This study evaluated the incidence of renal tubular damage, severity, and duration of the peri-op period using old and novel biomarkers. Methods: This prospective, randomised, and double-blinded clinical study involved 69 patients. Blood and urine samples were collected before and after anaesthesia, and serum creatinine (SCr), cystatin C (SCysC), and urinary N-Acetyl- β-D- glucosaminidase (uNAG) were assayed simultaneously with urea, uric acid, and electrolytes to detect renal tubular damage. Kidney Disease Improving Global Outcomes (KDIGO)-SCr and Translational Research in Biomarker Endpoint (TRIBE) – ScysC criteria used to define AKI. Results: The pre-to post-op alterations between SCr (73.50 (62.0-89.50) vs 72.50 (59.25-83.75), p=0.166) and SCysC (51.69 (47.50-62.90) vs 54.84 (51.70-61.82), p=0.100), and the incidence of AKI by KDIGO and TRIBE was 9.4% and 18.8%, respectively. Patients with AKI by KDIGO were all female whereas, for TRIBE, 17.2% females and 1.6% males. The Kaplan-Meier survival curve analysis for AKI based on KDIGO stratified by sex showed that at 63- and 172-minutes post-general anaesthesia (GA), the survival rate against AKI was 97.8% (95% CI: 93.7-100%) and 22.6% (77.4%; 95% CI: 60.5-99.1%) for females and on the contrary no incidence of AKI in male. With TRIBE at 58 minutes post-GA, the survival rate of males was 85.7% (95% CI: 63.3-100.0%) and females at 40 minutes, 72 minutes and 180 minutes were 98.2% (95% CI: 94.8-100.0%), 89.5% (95% CI: 81.1-98.7%) and 52.6% (95% CI: 32.9-84.0%), respectively. Conclusions: AKI was common among female adult general surgical patients undergoing GA. SCysC is a more sensitive marker in detecting AKI than SCr in adult general surgical patients.
Keywords
Acute kidney injury; perioperative; Serum creatinine; Serum cystatin C


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