New indicators in early term diagnosis of acute renal failure in diabetic patients after cardiac surgery: NGAL and cystatin C

Background: We aimed to investigate whether NGAL and Cystatin C which are early term indicators of acute renal failure in diabetic patients after cardiac surgery are superior to creatinine and glomerular filtrate rate.Material-Method: Forty four patients who were operated due to coronary artery disease between September 2011 ? December 2011 were included to study. Twenty two patients were diabetic and 22 patients were non-diabetic. Male / Female ratio was 33/11. Mean age was 61,4. All operations performed by cardiopulmonary bypass. NGAL and cystatin C values were compared to serum creatinine and glomerular filtrate rate preoperatively, after weaning from CPB and postoperative 1st and 2nd days. Early term diagnosis indicators of acute renal failure were investigated.Findings: There was no mortality in 44 patients. Acute renal failure did not develop in any patients. There was no significant difference between NGAL and cystatin C when diabetic and non-diabetic patients were compared. But significant difference was observed between 2 groups according to serum creatinine and glomerular filtrate rate which are still currently used.Result: Development risk of acute renal failure after CABG with CPB which is commonly used is high. Nephropathy is a microvascular complication of diabetes. Therefore, development risk of acute renal failure after CABG with CPB in diabetic patients is higher. Recent studies show that routinely usage of serum creatinine level and glomerular filtrate rate is insufficient to determine early term diagnosis of acute renal failure. In this context, early term indicators were investigated and studies were performed about NGAL and cystatin c. We did not find any significant difference in NGAL and cystatin c between diabetic and non-diabetic patients? preoperative and postoperative periods, however significant difference was observed in serum creatinine and glomerular filtrate rate which are still currently used. Increase of NGAL and cystatin c in both diabetic and non-diabetic groups suggests that these parameters also increase due to inflammatory response in CPB. Therefore further investigates are necessary.Key Words: Coronary artery dissease, Coronary artery bypass graft surgery, Acute Renal Failure