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Risk factor and correlation between postoperative serum myoglobin and acute kidney injury after pulmonary
Mingyuan Xu1,2, Yanan Zhen1,2, Zhaohua Zhang1,2
1Peking University China-Japan Friendship School of Clinical Medicine, Beijing, China.
Background:
Acute kidney injury (AKI) is a common and life-threatening complication following pulmonary endarterectomy (PEA). Our study aimed to investigate the risk factors associated with AKI and evaluate the correlation between serum myoglobin (sMb) levels and postoperative AKI.
Methods:
We conducted a retrospective study involving 134 patients who underwent PEA at China-Japan Friendship Hospital. AKI was defined and staged according to the Kidney Disease Improving Global Outcomes (KDIGO) criteria.
Results:
During the study period, the incidence of postoperative AKI was 57.5%, and the associated mortality rate was 6.0%. Severe AKI was found to be significantly associated with worse short-term outcomes (P<0.05). Logarithmically transformed postoperative day (POD) 0 sMb levels were significantly associated with AKI [odds ratio (OR) =5.174; 95% confidence interval (CI), 2.307-11.603; P<0.001] and severe AKI (OR =4.605; 95% CI, 1.510-14.048; P=0.007), also had independent predictive value [area under the curve (AUC) =0.776 in AKI and AUC =0.737 in severe AKI]. The optimal cut-off values were 370.544 ng/mL for AKI and 419.473 ng/mL for severe AKI. Furthermore, albumin concentration was found to play a protective role in the development of severe AKI (OR =0.838; 95% CI, 0.716-0.980; P=0.027) when higher than 40.350 g/L.
Conclusions:
Our findings suggest that a high concentration of POD0 sMb may increase the risk of developing AKI following PEA surgery. Increasing albumin concentration could serve as an effective preventive measure against AKI.
Insights
High serum myoglobin levels on postoperative day 0 are linked to acute kidney injury (AKI) after pulmonary endarterectomy (PEA). Albumin may help prevent AKI, suggesting targeted interventions for high-risk patients.
Area of Science:
- Nephrology
- Cardiothoracic Surgery
- Biomarkers
Background:
- Acute kidney injury (AKI) is a frequent and serious complication post-pulmonary endarterectomy (PEA).
- Identifying AKI risk factors and predictive biomarkers is crucial for patient outcomes.
Purpose of the Study:
- To investigate risk factors for AKI following PEA.
- To assess the correlation between serum myoglobin (sMb) levels and postoperative AKI.
Main Methods:
- Retrospective study of 134 patients undergoing PEA.
- AKI diagnosis and staging based on Kidney Disease Improving Global Outcomes (KDIGO) criteria.
- Analysis of serum myoglobin and albumin levels in relation to AKI incidence and severity.
Main Results:
- Postoperative AKI incidence was 57.5%, with a 6.0% mortality rate.
- Elevated postoperative day 0 serum myoglobin (sMb) was significantly associated with AKI (OR=5.174) and severe AKI (OR=4.605).
- Albumin concentration > 40.350 g/L showed a protective effect against severe AKI (OR=0.838).
Conclusions:
- High postoperative day 0 sMb levels are a significant risk factor for AKI after PEA.
- Albumin concentration may serve as a protective factor, suggesting its potential role in AKI prevention strategies.
- sMb demonstrates independent predictive value for AKI, with optimal cut-off values identified.
