Abstract
Objectives: Acute kidney damage (Acute kidney injury [AKI]) is defined by elevations in serum creatinine levels that occur after surgery. In cardiac surgery, creatinine is a critical determinant. This study highlights the detection of serum creatinine as an early diagnostic and predictive marker of AKI following coronary artery bypass grafting (CABG) and to estimate the serum creatinine concentrations before and at 24 and 48 h after CABG. Methods: It is a single center, Cross-sectional study. Patients from Cardiothoracic and Vascular surgery undergoing CABG in Sri Ramachandra Medical College and Research Institute were included in the study. A total of 80 cases were included in the study. The method used for measurement of serum creatinine is by modification of kinetic Jaffe reaction. Data were analyzed using Stata/SE version 16.0 and represented in terms of means, standard deviation at 95% confidence level and t’ test was performed as statistical analysis and p<0.05 indicates significance. Sigma plot software version 10.0 was used to draw the standard error mean graphs. Results: The serum creatinine values at 24 h after the surgery was statistically higher than the preoperative values at 5% significance level (p=0.04). The serum creatinine values 48 h after the surgery was also statistically higher than the preoperative values at 1% significance level (p=0.001). The serum creatinine values 48 h after surgery are highly significant (p=0.001) when compared to the serum creatinine values 24 h after surgery. Conclusion: Before an increase in serum creatinine level is detected, over 50% of renal function must be lost. It was concluded that serum creatinine is an inadequate and delayed marker of AKI.
Highlights
Acute kidney injury (AKI) is described as a sudden decrease in glomerular filtration rate (GFR), with clinical symptoms ranging from a little increase in blood creatinine to anuric renal failure [1]
The criterion used for diagnosis of AKI was the AKI Network (AKIN) definition and staging criteria
The serum creatinine values at 24 h after the surgery was statistically higher than the preoperative values at 5% significance level (p=0.04)
Summary
Acute kidney injury (AKI) is described as a sudden decrease in glomerular filtration rate (GFR), with clinical symptoms ranging from a little increase in blood creatinine to anuric renal failure [1]. The range of injuries varies from moderate to advance with renal replacement therapy sometimes. AKI is essentially driven by changes in serum creatinine evels perioperatively. In this increasingly common disorder, AKI is largely asymptomatic and is nowadays based on functional biomarkers such as serum creatinine and blood urea nitrogen [7,8,9]. Diagnosis of AKI is based on these functional biomarkers which are not very specific or sensitive because they are affected by many renal and non-renal factors [10]
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