NephroCheck as a Predictor of Acute Kidney Injury Following Coronary Artery Bypass Graft Surgery

Background Cardiac surgery-associated acute kidney injury (CSA-AKI) remains a significant complication following coronary artery bypass grafting (CABG), affecting 22%-30% of patients. This study evaluates the efficacy of NephroCheck, a biomarker-based test measuring insulin-like growth factor-binding protein 7 (IGFBP7) and tissue inhibitor of metalloproteinases-2 (TIMP2), in predicting postoperative AKI. Methods In this retrospective observational cohort study, 21 patients undergoing isolated CABG were analyzed. NephroCheck values were measured preoperatively, upon ICU admission, and at 24 hours post-admission. Patients with chronic kidney disease (CKD), heart failure, or preoperative serum creatinine of ≥2 mg/dL were excluded. AKI was defined using the Kidney Disease Improving Global Outcomes (KDIGO) criteria through postoperative day 7. Results Seven patients developed postoperative AKI. Preoperative NephroCheck values were significantly elevated in the AKI group compared to controls (1.34 (ng/ml)²/1000 ± 1.33 vs 0.54 (ng/ml)²/1000 ± 0.43, p = 0.009), while traditional renal function parameters showed no significant differences. Regression analysis identified preoperative NephroCheck as the only significant predictor of postoperative AKI (OR: 17.85, p = 0.047). Traditional risk factors, including preoperative renal function, Society of Thoracic Surgeons (STS) score, and operative times, showed no significant predictive value. Conclusions Preoperative NephroCheck testing demonstrates significant utility in predicting CSA-AKI following CABG, outperforming traditional risk assessment methods. These findings suggest that incorporating NephroCheck into routine preoperative assessments could enable more targeted preventive interventions, potentially reducing CSA-AKI incidence and its associated complications.