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Plasma renalase level as biomarker of ischemic acute kidney injury following cardiac surgery / Hussein Hassan Samir Mohammed Refaat ; Supervised Manal Mohammed Nabih Eldeeb , Amal Abdelwahab Mohammed , Ihab Abdelrahman Ibrahim

By: Contributor(s): Material type: TextTextLanguage: English Publication details: Cairo : Hussein Hassan Samir Mohammed Refaat , 2016Description: 178 P. : charts ; 25cmOther title:
  • مستوى انزيم الريناليز كعلامة حيوية لنقص تروية الكلى الحاد بعد جراحة القلب [Added title page title]
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Dissertation note: Thesis (Ph.D.) - Cairo University - Faculty of Medicine - Department of Internal Medicine Summary: Background/Objective: Renal ischemia/reperfusion injury (IRI) is a major cause of acute renal failure. The scarcity of early biomarkers and validated risk models for predicting acute kidney injury (AKI) has hindered our ability to launch preventive and therapeutic measures in a timely manner. We tested the hypothesis that plasma renalase is an early biomarker for ischaemic renal injury after cardiac surgery. Methods This study prospectively evaluated 40 adult patients who underwent cardiac surgery at Cairo University Hospitals. Demographic factors, clinical data, operative and postoperative variables were evaluated. Plasma renalase levels, analysed by ELISA were measured before surgery and 18 - 24 hours after surgery. NGAL levels, analysed by ELISA. were measured 18 - 24 hours after surgery. The primary outcome measure was AKI diagnosed by the Acute Kidney Injury Network (AKIN) criteria. Results Of 40 patients, 25 patients (62.5 %) developed AKI after surgery. Plasma concentrations of renalase decreased significantly from a mean of 1.2 ± 0.46 ng/ml at baseline to 0.9 ± 0.42 ng/ml 18 - 24 hours after cardiopulmonary bypass, with a mean % change of 27 ± 14.8 in the AKI group. Univariate analysis showed statistically significant correlation between acute renal injury and the following: percent (%) change of plasma renalase levels, cardiopulmonary bypass time and Aortic cross- clamp time. Receiver operating characteristic (ROC) analysis revealed that for % change in plasma renalase concentrations at 18 - 24 h, the AUC was 0·9, sensitivity 0.92, specificity 0·87, PPV was 0.92, NPV was 0.87 and likelihood ratio of 7.07 for a cutoff value of 9 % change. Conclusion Plasma renalse percent (%) of change is more valid compared to renalse before or after procedure and NGAL in prediction of AKI and represents a sensitive, specific, and highly predictive early biomarkers for acute renal injury after cardiac surgery.
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Thesis Thesis قاعة الرسائل الجامعية - الدور الاول المكتبة المركزبة الجديدة - جامعة القاهرة Cai01.11.18.Ph.D.2016.Hu.P (Browse shelf(Opens below)) Not for loan 01010110070199000
CD - Rom CD - Rom مخـــزن الرســائل الجـــامعية - البدروم المكتبة المركزبة الجديدة - جامعة القاهرة Cai01.11.18.Ph.D.2016.Hu.P (Browse shelf(Opens below)) 70199.CD Not for loan 01020110070199000

Thesis (Ph.D.) - Cairo University - Faculty of Medicine - Department of Internal Medicine

Background/Objective: Renal ischemia/reperfusion injury (IRI) is a major cause of acute renal failure. The scarcity of early biomarkers and validated risk models for predicting acute kidney injury (AKI) has hindered our ability to launch preventive and therapeutic measures in a timely manner. We tested the hypothesis that plasma renalase is an early biomarker for ischaemic renal injury after cardiac surgery. Methods This study prospectively evaluated 40 adult patients who underwent cardiac surgery at Cairo University Hospitals. Demographic factors, clinical data, operative and postoperative variables were evaluated. Plasma renalase levels, analysed by ELISA were measured before surgery and 18 - 24 hours after surgery. NGAL levels, analysed by ELISA. were measured 18 - 24 hours after surgery. The primary outcome measure was AKI diagnosed by the Acute Kidney Injury Network (AKIN) criteria. Results Of 40 patients, 25 patients (62.5 %) developed AKI after surgery. Plasma concentrations of renalase decreased significantly from a mean of 1.2 ± 0.46 ng/ml at baseline to 0.9 ± 0.42 ng/ml 18 - 24 hours after cardiopulmonary bypass, with a mean % change of 27 ± 14.8 in the AKI group. Univariate analysis showed statistically significant correlation between acute renal injury and the following: percent (%) change of plasma renalase levels, cardiopulmonary bypass time and Aortic cross- clamp time. Receiver operating characteristic (ROC) analysis revealed that for % change in plasma renalase concentrations at 18 - 24 h, the AUC was 0·9, sensitivity 0.92, specificity 0·87, PPV was 0.92, NPV was 0.87 and likelihood ratio of 7.07 for a cutoff value of 9 % change. Conclusion Plasma renalse percent (%) of change is more valid compared to renalse before or after procedure and NGAL in prediction of AKI and represents a sensitive, specific, and highly predictive early biomarkers for acute renal injury after cardiac surgery.

Issued also as CD

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