Plasma Neutrophil Gelatinase-Associated Lipocalin and Interleukin-9 as Acute Kidney Injury Predictors After Coronary Artery Bypass Graft Following Cardiopulmonary Bypass

Abstract

Background: Acute Kidney Injury (AKI) incidence of postoperative Coronary Artery Bypass Graft (CABG) with Cardipulmonary Bypass (CPB) at Dr. Soetomo General Academic Hospital reached 69.8%, higher than the global average of 5-20%. Predictors of postoperative AKI are needed; potential biomarkers include plasma Neutrophil Gelatinase-Associated Lipocalin (NGAL) and Interleukin-9 (IL-9). This study aims to analyze the predictive ability of these two biomarkers. Methods: This is a prospective observational study in CABG patients with CPB without previous renal abnormalities at Dr. Soetomo in September-December 2020. Examination of plasma NGAL and IL-9 was carried out before, during, and after the CPB procedure. Results: 21 patients were included in the study, 17 people (81.0%) were male. AKI experienced 14 people (66.7%); 3 people (14.3%) died. Patients without AKI had higher plasma NGAL results at preinduction (17.9±10.3 vs 17.1±15.5), durante (20.5±8.2 vs 16.9±7.8), and early ICU (24.0±8.6 vs 22.9±10.4). Patients with AKI had higher plasma IL-9 results at preinduction (63.3±23.2 vs 55.7±15.8), durante (45.2±11.0 vs 44.2±9.2), and early ICU (49.6±11.3 vs 46.2±15.6). There was no statistically significant relationship between plasma NGAL and IL-9 results. Conclusion: Most CABG patients undergoing CPB have AKI. Patients without AKI had higher NGAL results and lower IL-9 in plasma. Statistically, neither of them can be used as predictive biomarkers of the incidence of AKI so far.