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Perioperative Marinobufagenin (MBG) Measurement May Improve Acute Kidney Injury Risk Assessment in Patients Undergoing Major Cardiac Surgery: A Proof-of-Concept Study.
- Source :
-
Medicina (Kaunas, Lithuania) [Medicina (Kaunas)] 2024 Jun 30; Vol. 60 (7). Date of Electronic Publication: 2024 Jun 30. - Publication Year :
- 2024
-
Abstract
- Background and Objectives: Acute kidney injury (AKI) remains a significant complication following major cardiac surgery. Marinobufagenin (MBG), a cardiotonic steroid involved in sodium balance and blood pressure regulation, has been linked to organ damage after ischemia-reperfusion events. This pilot, prospective study investigates the utility of circulating MBG to improve AKI risk assessment in cardiac surgery patients as a stand-alone biomarker and after inclusion in a validated risk model (STS-AKI score). Materials and Methods: We included 45 patients undergoing elective cardiac surgery. The MBG levels were measured preoperatively and at 4, 8, and 12 h post-surgery. The AKI was defined according to the KDIGO guidelines. Statistical analyses assessed the diagnostic and prognostic utility of MBG and its integration with the STS-AKI score. Results: An AKI occurred in 26.7% of the patients. The STS-AKI score performed well in this cohort (AUC: 0.736). The MBG levels displayed a decreasing trend in the whole population after surgery ( p = 0.02). However, in the AKI patients, MBG increased at 4 and 8 h before decreasing at 12 h post-surgery. The MBG changes from the baseline to 8 h and from 8 to 12 h post-surgery showed a remarkable diagnostic accuracy for an AKI (AUCs: 0.917 and 0.843, respectively). Integrating these MBG changes with the STS-AKI score significantly improved the model performance, including discrimination, calibration, and risk reclassification. Conclusions : The MBG measurement, particularly any dynamic changes post-surgery, enhances AKI risk stratification in cardiac surgery patients. Integrating MBG with the STS-AKI score offers more accurate risk predictions, potentially leading to better patient management and outcomes.
- Subjects :
- Humans
Male
Female
Prospective Studies
Aged
Risk Assessment methods
Pilot Projects
Middle Aged
Proof of Concept Study
Postoperative Complications blood
Postoperative Complications prevention & control
Postoperative Complications diagnosis
Acute Kidney Injury etiology
Acute Kidney Injury diagnosis
Acute Kidney Injury blood
Acute Kidney Injury prevention & control
Bufanolides blood
Cardiac Surgical Procedures adverse effects
Biomarkers blood
Subjects
Details
- Language :
- English
- ISSN :
- 1648-9144
- Volume :
- 60
- Issue :
- 7
- Database :
- MEDLINE
- Journal :
- Medicina (Kaunas, Lithuania)
- Publication Type :
- Academic Journal
- Accession number :
- 39064508
- Full Text :
- https://doi.org/10.3390/medicina60071079