Acute Kidney Injury After Open Heart Surgery: The Diagnostic and Predictive Value of The New Biomarkers

Background Post-operative acute kidney injury (AKI) following cardiac surgery represents a significant clinical challenge, associated with heightened mortality and an increased propensity for chronic kidney disease. Ischemia-reperfusion injury, a primary pathophysiological mechanism, induces renal tubular damage, releasing biomarkers such as Neutrophil gelatinase-associated lipocalin (NGAL) and hemojuvelin (HJV) into the urine. The quantification of these urinary biomarkers offers a means for early AKI detection and risk stratification, with the potential to improve patient prognosis. Aim This investigation tested new urinary biomarkers to detect AKI within the first 24 hours, to enable prompt intervention and enhance patient care. Patients and Method Sixty-three patients undergoing open heart surgery were divided into the AKI group (n=18, met Kidney Disease Improving Global Outcomes (KDIGO) conditions and without AKI (W-AKI) group (n=45). All received pre/post-op serum (urea, creatinine, electrolytes) and urine volume measurements. Within the first 24 hours post-operation, including initial, early, and intermediate time points, urine HJV and urinary NGAL (ELISA) were assessed. Results HJV & NGAL levels remained stable in the (W-AKI) group postoperatively. Still, they significantly increased in the acute injury group at the different time points compared to their baseline and the non-AKI group. Conclusion Our study revealed a significant improvement in early AKI detection accuracy using HJV and urinary NGAL biomarkers.