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Prognostic value of postoperative proteinuria in cardiac surgery: a pilot study
Keyvan Karkouti1, Shahriar Shayan, Duminda N Wijeysundera
1University Health Network, Toronto General Hospital, Department of Anesthesia, EN 3-402, 200 Elizabeth Street, Toronto, Ontario M5G 2C4, Canada. keyvan.karkouti@uhn.on.ca
Summary
Postoperative proteinuria after cardiac surgery may indicate systemic capillary leak and predict adverse outcomes. Early detection of proteinuria can help identify patients at higher risk for prolonged ICU stays and organ dysfunction.
Area of Science:
- Cardiology
- Nephrology
- Critical Care Medicine
Background:
- Proteinuria, a marker of inflammation, may indicate glomerular involvement in systemic capillary leak.
- This pilot study investigated the association between postoperative proteinuria and adverse outcomes in cardiac surgery patients.
Purpose of the Study:
- To determine if proteinuria after cardiac surgery with cardiopulmonary bypass is linked to adverse postoperative outcomes.
- To explore proteinuria as a potential indicator of systemic capillary leak.
Main Methods:
- 197 patients undergoing cardiac surgery with cardiopulmonary bypass were included.
- Urine protein-to-creatinine ratio was measured postoperatively.
- Adverse events included prolonged ICU stay and organ dysfunction, analyzed using logistic regression.
Main Results:
- Postoperative proteinuria (protein creatinine ratio >= 30 g.mol(-1)) was significantly associated with prolonged ICU stay (OR 7.0) and organ dysfunction (OR 3.9).
- Adjusted analysis revealed proteinuria increased the odds of prolonged ICU stay (3.2-fold) and organ dysfunction (3.2-fold).
Conclusions:
- Early postoperative proteinuria may serve as a valuable marker for systemic capillary leak and adverse events after cardiac surgery.
- Further large-scale prospective studies are warranted to validate these findings.