Cistatina C e taxa de filtração glomerular em cirurgia cardíaca com circulação extracorpórea
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Data
2009-09-01
Autores
Felicio, Marcello Laneza [UNESP]
Andrade, Rubens Ramos de [UNESP]
Castiglia, Yara Marcondes Machado [UNESP]
Silva, Marcos Augusto de Moraes [UNESP]
Vianna, Pedro Thadeu Galvão [UNESP]
Martins, Antonio Sérgio [UNESP]
Título da Revista
ISSN da Revista
Título de Volume
Editor
Sociedade Brasileira de Cirurgia Cardiovascular
Resumo
OBJETIVO: Avaliar a cistatina C como marcador de função renal em pacientes submetidos à cirurgia de cardíaca com circulação extracorpórea, comparando com a dosagem sérica de creatinina. MÉTODOS: Foram analisados 50 pacientes consecutivos submetidos à cirurgia de revascularização do miocárdio. A função renal foi avaliada com a dosagem sérica de cistatina C e de creatinina no pré-operatório, no primeiro e no quinto dia de pós-operatório. Foram utilizadas as fórmulas de Cockcroft-Gault (CG) e Modification of Diet in Renal Disease (MDRD) para calcular a taxa de filtração glomerular estimada (TFG) através da creatinina, e a fórmula de Larsson para a TFG estimada através da cistatina C (TFG-Cis). RESULTADOS: A creatinina e o TFG através das fórmulas de CG e MDRD não mostraram diferença significativa nos momentos estudados. Após a agressão renal pela cirurgia, houve um aumento da cistatina C no 1º e 5º pós-operatório, sendo que no 5º pós-operatório com diferença estatisticamente significativa (P < 0,01). Houve uma queda da TFG estimada pela cistatina C de 105,2 ± 41,0 ml/min, no pré-operatório, para 89,5 ± 31,5 ml/min no 5º dia pós-operatório (P < 0,012). CONCLUSÃO: A cistatina C e a TFG-Cis apresentaram mudanças significativas no pós-operatório de cirurgia de revascularização do miocárdio quando comparadas a creatinina e a respectiva TFG estimada pelas fórmulas de Cockcroft-Gault e MDRD
OBJECTIVE: The aim of this study was to compare cystatin C versus creatinine as a marker for acute kidney injury in patients submitted to cardiac surgery with cardiopulmonary bypass. METHODS: Fifty consecutive patients submitted to coronary artery bypass grafting were studied. Renal function was evaluated by serum cystatin C and creatinine. Blood samples were obtained from each patient at three time points: before operation, and on the first and fifth postoperative days. Glomerular filtration rate (GFR) was calculated by Cockcroft-Gault (CG), Modification of Diet in Renal Disease (MDRD), and Larsson (Cys-GFR) formulas. RESULTS: Creatinine and GFR by CG and MDRD formulas did not show statistical difference between study times. After renal injury from surgery, there was an increase in cystatin C on the 1st and 5th day after surgery, being significantly different on the 5th postoperative (P<0.01). The GFR by Larson formula was higher in the preoperative time (105.2 ± 41.0 ml/min) than in the 5th postoperative day (89.5± 31.5 ml/min; P<0.012). CONCLUSION: The cystatin C and the Cys-GFR showed significant changes after cardiac surgery when compared with the creatinine and respective GFR calculated by the Cockcroft-Gault and MDRD formulas.
OBJECTIVE: The aim of this study was to compare cystatin C versus creatinine as a marker for acute kidney injury in patients submitted to cardiac surgery with cardiopulmonary bypass. METHODS: Fifty consecutive patients submitted to coronary artery bypass grafting were studied. Renal function was evaluated by serum cystatin C and creatinine. Blood samples were obtained from each patient at three time points: before operation, and on the first and fifth postoperative days. Glomerular filtration rate (GFR) was calculated by Cockcroft-Gault (CG), Modification of Diet in Renal Disease (MDRD), and Larsson (Cys-GFR) formulas. RESULTS: Creatinine and GFR by CG and MDRD formulas did not show statistical difference between study times. After renal injury from surgery, there was an increase in cystatin C on the 1st and 5th day after surgery, being significantly different on the 5th postoperative (P<0.01). The GFR by Larson formula was higher in the preoperative time (105.2 ± 41.0 ml/min) than in the 5th postoperative day (89.5± 31.5 ml/min; P<0.012). CONCLUSION: The cystatin C and the Cys-GFR showed significant changes after cardiac surgery when compared with the creatinine and respective GFR calculated by the Cockcroft-Gault and MDRD formulas.
Descrição
Palavras-chave
Cistatinas, Circulação extracorpórea, Creatinina, Cystatins, Extracorporeal circulation, Creatinine
Como citar
Revista Brasileira de Cirurgia Cardiovascular. Sociedade Brasileira de Cirurgia Cardiovascular, v. 24, n. 3, p. 305-311, 2009.