None listed
Conditions
Brief summary
Acute kidney injury (AKI) is a frequent and serious complication after cardiac surgery. Current diagnostic methods rely on blood tests and urine output, which often detect AKI only after significant kidney damage has occurred. This prospective cohort study will assess whether the urine albumin-to-creatinine ratio (uACR), a simple and inexpensive urine test, can predict AKI earlier. We will enroll 200 adult patients undergoing cardiac surgery at Austin Hospital. Urine samples will be collected at three time points: before surgery, at admission to the intensive care unit, and the following morning. Our hypothesis is that patients with rising uACR after surgery will have a higher risk of developing acute kidney injury. Early identification could allow timely preventive strategies and improve patient outcomes.
Interventions
Measurement of Urinary Albumin-to-Creatinine Ratio (uACR) in Cardiac Surgery Patients.
Urinary albumin-to-creatinine ratio (uACR) will be measured at three time points in patients undergoing cardiac surgery and compared to the reference assessment of neutrophil-gelatinase-associated lipocalin (NGAL):
1) A preoperative sample collected in the operating room,
2) A sample collected at within 4 hours of intensive care unit admission following surgery, and
3) A sample collected on the morning of pos
Measurement of Urinary Albumin-to-Creatinine Ratio (uACR) in Cardiac Surgery Patients. Urinary albumin-to-creatinine ratio (uACR) will be measured at three time points in patients undergoing cardiac surgery and compared to the reference assessment of neutrophil-gelatinase-associated lipocalin (NGAL): 1) A preoperative sample collected in the operating room, 2) A sample collected at within 4 hours of intensive care unit admission following surgery, and 3) A sample collected on the morning of postoperative day 1. On weekdays, the investigating team will identify patients scheduled for cardiac surgery from the surgical list and screen them for eligibility. For each eligible patient, the investigator will collect the first urine sample after insertion of the urinary catheter in the operating theatre. A second sample will be obtained within 4 hours of intensive care unit admission after surgery, and a third sample will be collected the following morning (postoperative day 1) after intensive care unit admission. All urine samples will be collected via the existing indwelling urinary catheter, in accordance with institutional policies and procedures for the collection and handling of biological specimens.
Sponsors
Austin Health
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Patients aged equal to or greater than 18 years Having cardiac surgery (aortic surgery requiring bypass, valvular surgery, coronary artery bypass grafting or in combination) in Austin Hospital Preoperative with estimate Glomerular Filtration Rate (eGFR) greater than or equal to 30 milliliters per minute per 1.73 meters squared Admitted to the intensive care unit following cardiac surgery Has an indwelling urinary catheter in place
Exclusion criteria
End-stage renal disease requiring regular dialysis Post kidney transplantation Preadmission chronic kidney disease with (eGFR) less than 30 milliliters per minute per 1.73 meters squared Need for extracorporeal membrane oxygenation Known or suspected pregnancy
Outcome results
None listed