PMID- 28072936
OWN - NLM
STAT- MEDLINE
DCOM- 20170823
LR  - 20190319
IS  - 0310-057X (Print)
IS  - 0310-057X (Linking)
VI  - 45
IP  - 1
DP  - 2017 Jan
TI  - Haptoglobin and free haemoglobin during cardiac surgery-is there a link to acute 
      kidney injury?
PG  - 58-66
AB  - Acute kidney injury (AKI) is frequently observed after cardiac surgery (CS) with 
      cardiopulmonary bypass (CPB). Multiple mechanisms underlie this phenomenon, 
      including CPB-dependent haemolysis. Haemoglobin is released during haemolysis, 
      and free haemoglobin (frHb) causes tubular cell injury after exceeding the 
      binding capacity of haptoglobin (Hp). The objective of this study was to 
      investigate the influence of perioperative changes in frHb and Hp levels on the 
      incidence of CS-associated (CSA) AKI. After receiving local ethics committee 
      approval and obtaining informed consent from our patients, we analysed the data 
      pertaining to 154 patients undergoing CPB surgery. We recorded frHb and Hp 
      concentrations pre-, intra- and postoperatively and defined AKI using the Kidney 
      Disease Improving Global Outcomes (KDIGO) classification. We observed that frHb 
      levels increased significantly during surgery and then decreased at ten hours 
      thereafter and that Hp levels decreased during surgery and remained at low levels 
      until the first postoperative day. We noted a moderate negative correlation 
      between frHb and Hp levels. AKI was identified in 45.5% of patients; however, 
      there was no significant difference in frHb or Hp levels between patients with 
      and without AKI. We did not observe a relationship between frHb or Hp levels and 
      CSA AKI and thus could not confirm the hypothesis that patients with higher 
      baseline Hp concentrations experience a lower incidence of AKI than patients with 
      lower baseline Hp concentrations.
FAU - Wetz, A J
AU  - Wetz AJ
AD  - Anaesthetist, Department of Anaesthesiology, University of Goettingen, 
      Goettingen, Germany.
FAU - Richardt, E M
AU  - Richardt EM
AD  - Doctoral student, Department of Anaesthesiology, University of Goettingen, 
      Goettingen, Germany.
FAU - Schotola, H
AU  - Schotola H
AD  - Anaesthetist, Department of Anaesthesiology, University of Goettingen, 
      Goettingen, Germany.
FAU - Bauer, M
AU  - Bauer M
AD  - Anaesthetist, Professor, Department of Anaesthesiology, University of Goettingen, 
      Goettingen, Germany.
FAU - Brauer, A
AU  - Brauer A
AD  - Anaesthetist, Professor, Department of Anaesthesiology, University of Goettingen, 
      Goettingen, Germany.
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Anaesth Intensive Care
JT  - Anaesthesia and intensive care
JID - 0342017
RN  - 0 (Haptoglobins)
RN  - 0 (Hemoglobins)
SB  - IM
MH  - *Acute Kidney Injury
MH  - *Cardiac Surgical Procedures
MH  - Cardiopulmonary Bypass
MH  - *Haptoglobins
MH  - Hemoglobins
MH  - Humans
MH  - *Postoperative Complications
MH  - Risk Factors
OTO - NOTNLM
OT  - coronary artery bypass surgery, acute kidney injury, free haemoglobin, 
      haptoglobin
EDAT- 2017/01/11 06:00
MHDA- 2017/08/24 06:00
CRDT- 2017/01/11 06:00
PHST- 2017/01/11 06:00 [entrez]
PHST- 2017/01/11 06:00 [pubmed]
PHST- 2017/08/24 06:00 [medline]
AID - 20160482 [pii]
AID - 10.1177/0310057X1704500109 [doi]
PST - ppublish
SO  - Anaesth Intensive Care. 2017 Jan;45(1):58-66. doi: 10.1177/0310057X1704500109.