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Updated: Feb 7, 2026
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A Large Animal Model for Acute Kidney Injury by Temporary Bilateral Renal Artery Occlusion
Published on: February 2, 2021
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Persistent decrease of renal functional reserve in patients after cardiac surgery-associated acute kidney injury
Faeq Husain-Syed1,2,3, Fiorenza Ferrari1, Aashish Sharma1
1International Renal Research Institute of Vicenza, San Bortolo Hospital, Vicenza, Italy.
Summary
Cardiac surgery can impair kidney function, leading to acute kidney injury (AKI) and chronic kidney disease (CKD). Renal functional reserve (RFR) may decrease even with normal creatinine levels post-surgery.
Area of Science:
- Nephrology
- Cardiology
- Biomarkers
Background:
- Cardiac surgery is a primary cause of acute kidney injury (AKI), potentially leading to chronic kidney disease (CKD).
- Some patients may experience a loss of renal functional reserve (RFR) even if serum creatinine levels normalize post-surgery.
Purpose of the Study:
- To assess changes in renal functional reserve (RFR) at 3 months post-cardiac surgery.
- To investigate the association between post-operative AKI, cell cycle arrest (CCA) biomarkers, and RFR.
- To determine if RFR can predict the development of new chronic kidney disease (CKD) after cardiac surgery.
Main Methods:
- Extended follow-up of 86 patients with normal baseline eGFR from a previous study.
- Re-measured RFR using a high oral protein load at 3 months post-discharge.
- Stratified patients based on post-operative AKI and CCA biomarker status.
Main Results:
- Three patients developed new CKD within 3 months; two had AKI, one had positive CCA biomarkers.
- Patients with post-operative AKI showed a significant decrease in RFR (P < 0.001).
- Patients with normal eGFR but positive CCA biomarkers also exhibited a significant RFR decrease (P < 0.001).
Conclusions:
- Post-operative AKI or elevated CCA biomarkers are linked to reduced RFR at 3 months, irrespective of serum creatinine normalization.
- RFR, in conjunction with biomarkers, may offer a valuable tool for assessing renal recovery post-cardiac surgery.
- Further prospective studies are recommended to validate RFR and biomarkers for monitoring renal outcomes.
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