None listed
Conditions
Brief summary
In this prospective observational study, adult participants undergoing elective cardio thoracic surgery requiring cardiopulmonary bypass are assessed preoperatively by a kidney functional reserve test and by kidney damage biomarkers (i.e., urine DKK3) and postoperatively by kidney damage and stress biomarkers (i.e., urine KIM-1, urine NGAL, urine Nephrocheck) for the first 3 postoperative days. These will be assessed as predictors of AKI as per KDIGO guidelines within the first 3 postoperative days. Kidney function will be assessed by serum creatinine within 1 and 3 years after the surgery. The hypothesis is that the suggested preoperative assessment will help to identify people at higher risk of developing postoperative AKI and that postoperative AKI defined by kidney damage and stress biomarkers will identify people at higher risk of developing worsening kidney function at long-term (i.e.: 1 and 3 years after the surgery).
Interventions
No intervention.
Exposure is the need of elective cardio thoracic surgery requiring cardiopulmonary bypass in adults.
- what is involved for patients in this study: Recruited patients will have blood and urine samples collected before and after cardiac surgery, for kidney biomarkers measurement. Preoperative assessment also includes an oral protein shake to allow for evaluation of the preoperative kidney functional reserve. Clinical data will be collected from medical records and from the pati
No intervention. Exposure is the need of elective cardio thoracic surgery requiring cardiopulmonary bypass in adults. - what is involved for patients in this study: Recruited patients will have blood and urine samples collected before and after cardiac surgery, for kidney biomarkers measurement. Preoperative assessment also includes an oral protein shake to allow for evaluation of the preoperative kidney functional reserve. Clinical data will be collected from medical records and from the patients. - what is being observed in participants: postoperative acute kidney injury incidence within the first 3 postoperative days, cardiac and renal complications, long-term kidney function within 1 and 3 years after the surgery, quality of life as per questionnaires. - the anticipated time required to complete each assessment is: 1. SF36 questionnaire (at the time of first assessment, then online after 1 and 3 months): 15 minutes to complete the questionnaire each time; 2. symptoms questionnaire at day 5-7 after surgery: 5 minutes to complete the questionnaire; 3. preoperative kidney functional reserve test for participants who agree to do it: 6 hours, at a single time before the surgery. - the overall duration of observation: from time of enrolment for 3 years.
Sponsors
Professor Zoltan Endre, Nephrology Department at Prince of Wales Hospital
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Adult patients undergoing elective cardio thoracic surgery requiring cardiopulmonary bypass.
Exclusion criteria
1. History of malabsorption or chronic inflammatory bowel disease or short bowel syndrome (precluding preoperative assessment using a protein load) 2. History of pancreatic insufficiency (precluding preoperative assessment using a protein load) 3. Chronic Kidney Disease (CKD) stage 5 (eGFR < 15 ml/min/1.73m2) 4. Known pregnancy
Outcome results
None listed