Neutrophil Gelatinase-associated Lipocalin as a Biomarker for Predicting Acute Kidney Injury After Coronary Artery Bypass Grafting

Abstract

Acute kidney injury is a frequent complication after cardiac surgery. According to the literature and the various definitions of acute kidney injury, cardiac surgery associated kidney injury may concern 1% to 30%of the patients. Mortality raises from 1% up to 50% for patients who undergo renal replacement therapy following cardiac surgery (Thiele et al., 2015). Early detection of renal dysfunction is often presented as a “holy grail” because it could allow interventions (both diagnostic and therapeutic) to prevent evolution to renal failure (Bataille et al., 2017). Serum creatinine reflects the balance between the synthesis of creatinine and its excretion by the kidney. Creatinine production in the body varies with muscle mass, physical activity, protein intake, and catabolism while creatinine excretion is dependent on the glomerular filtration rate (GFR). The serum creatinine and GFR are inversely and exponentially related. Halving of GFR implies that there will be doubling of creatinine concentration. There are several limitations for creatinine as a marker of kidney injury in acute perioperative situations. However, it has a poor, predictive accuracy for kidney injury, particularly in the early stages of AKI (Mcilroy & Sladen, 2015).