INFORMATIVITY OF RADIONUCLIDE RENAL SCINTIGRAPHY AND BIOCHEMICAL MARKERS IN DETECTION OF RENAL DYSFUNCTION IN PATIENTS UNDERGOING MYOCARDIAL REVASCULARIZATION

Abstract

A cute renal injury (AKI) is a common complication of cardiac surgery. Diagnostic criteria of acute renal dysfunction based on serum creatinine concentrations do are not suitable for early detection of AKI. Purpose. To evaluate the diagnostic significance of radionuclide scintigraphy and biochemical markers in the detection of renal dysfunction in patients with coronary artery disease (CAD) in the early postoperative period after coronary artery bypass grafting (CABG). Material and methods. A randomized controlled trial comprised a total of 108 CAD patients (all men aged 54.94 ± 0.72 years) who underwent direct myocardial revascularization by CABG. All patients received dynamic renal scintigraphy with 99mТс-DTPA and blood tests measuring serum concentrations of creatinine, lipocalin (NGAL), and Cystatin C before and after CABG. Results. After CABG, the mean values of total glomerular filtration rate (GFR) and GFR for each kidney significantly decreased whereas the serum concentrations of neutrophil gelatinase-associated lipocalin (NGAL) and Cystatin С in blood serum significantly increased. In the postoperative period, the creatinine clearance also significantly decreased. Statistical analysis revealed direct correlations of cardiopulmonary bypass duration with the changes in GFR (R = 0.42; P = 0.017) and s-NGAL (R = 0.39, P = 0.02) in cardiac surgery patients. Conclusion. Radionuclide method is not inferior to testing biochemical markers in the evaluation of early postoperative renal dysfunction in regard to diagnostic value and informativeness.