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Biomarkers That Forecast Cardiac Surgery Associated Acute Kidney Injury
Patients who present for cardiac surgery often have multiple comorbidities that increase their risk profile for a variety of outcome measures after surgery. Acute kidney injury (AKI) is unfortunately an all too common, undesirable event in this population. In this issue of Anesthesia & Analgesia, Verwijmeren et al present a secondary analysis of a 2-center, prospective cohort study in which elderly patients presenting for cardiac surgery were assessed throughout a variety of serum biomarkers preoperatively. A panel of 12 such biomarkers falling into 1 of 4 categories (renal, metabolic, cardiovascular, and inflammatory) was obtained, and the investigators used multivariable logistic regression analysis to find associations between these markers and the risk of developing AKI. Eighty-eight of 539 patients analyzed developed AKI (16.3%). Of the 12 biomarkers, N-terminal pro B-type natriuretic peptide, high-sensitivity C-reactive protein, hemoglobin, and magnesium demonstrated the highest correlation with the risk of cardiac surgery–associated AKI. This study considers the possibility of using commonly available blood tests to better discriminate for patients at higher risk for kidney injury after cardiac surgery. The reader is strongly encouraged to read the study for a comprehensive understanding of its methods, outcomes, and limitations.
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1. Verwijmeren L, Bosma M, Vernooij LM, et al. Associations between preoperative biomarker and cardiac surgery associated acute kidney injury in elderly patients: a cohort study. Anesth Analg. 2021;133:570–577.