The Role of Thiol-Disulfide Hemostasis in Predicting Renal İnjury After Coronary Artery Bypass Graft Surgery

Yıl 2021, Cilt: 3 Sayı: 1, 29 - 35, 23.01.2021

Mehmet Tercan , Gülçin Patmano , Ahmet Kaya , Uğur Yürekli Bişar Amaç , Mesut Engin

https://doi.org/10.37990/medr.796076

Öz

Aim: EInflammation andoxidative stres play an active role in renal injury that develops after open heart operations as in many diseases. There is a balance between oxidants and antioxidant defense mechanisms, and in the morbidity of cardiac surgery patients, this balance is thought to change depending on many factors.
Materials and Methods: 76 patients scheduled for coronary artery bypass graft surgery were included in the study. Demographic and operation information of the patients were recorded. In addition to routine blood parameters, blood samples were taken forthiol / disulfid hemostasis parameters. Patients who did not develop acut kidney injury (AKI) after the operation were recorded as Group 1 and those who developed register as Group 2.
Results: Postoperative AKI developed in 19 (25%) patients included in the study. When the thiol-disulfide hemostasis parameter values obtained from the blood sample taken within the first 2 hours after the introduction of intensive care after the operation of the patients, there was no difference between the two groups in terms of native thiol, total thiol, disulfide / native thiol and native thiol / total thiol values. In Group 2, disufide and disulfide / total thiol values were significantly higher (P = 0.018, P = 0.009).
Conclusion: We believe that the values of disulfide and disulfide / total thiol ratio, which are among the parameters of thiol-disulfide hemostasis, in the postoperative period may be predictors for AKI.

Anahtar Kelimeler

oxidative stres parameters, thiol levels, disulfide, kidney injury, cardiac surgery

Kaynakça

• 1. Pickering JW, James MT, Palmer SC. Acute kidney injury and prognosis after cardiopulmonary bypass: a meta-analysis of cohort studies. Am J Kidney Dis 2015; 65:283-93.
• 2. De Santo LS, Romano G, Mango E, Iorio F, Savarese L, Numis F, et al. Age and blood transfusion: relationship and prognostic implications in cardiac surgery. J Thorac Dis. 2017;9(10):3719-27
• 3. Jyrala A, Weiss RE, Jeffries RA, Kay GL. Effect of mild renal dysfunction (s-crea 1,2-2,2 mg/dl) on presentation characteristics and short- and long-term outcomes of on-pump cardiac surgery patients. Interact Cardiovasc Thorac Surg. 2010;10(5):777-82
• 4. Arthur JM, Hill EG, Alge JL, Lewis EC, Neely BA, Janech MG, et al.; SAKInet Investigators. Evaluation of 32 urine biomarkers to predict the progression of acute kidney injury after cardiac surgery. Kidney Int 2014; 85:431-8
• 5. Parlar H, Saskın H. Are Pre and Postoperative Platelet to Lymphocyte Ratioand Neutrophilto Lymphocyte Ratio Associated with Early Postoperative AKI Following CABG? Braz J Cardiovasc Surg. 2018 May-Jun;33(3):233-241.
• 6. Kundi H, Ates I, Kiziltunc E, Cetin M, Cicekcioglu H, Neselioglu S, et al. A novel oxidative stress marker in acute myocardial infarction; thiol/ disulphide homeostasis. Am J Emerg Med 2015; 33:1567–71.
• 7. Ayar G, Sahin S, Yazici MU, Neselioglu S, Erel O, Bayrakcı US. Effects of Hemodialysis on Thiol-Disulphide Homeostasis in Critically Ill Pediatric Patients with Acute Kidney Injury. Biomed Res Int. 2018 Sep 25; 2018:1898671.
• 8. Lopes JA, Fernandes P, Jorge S, Gonçalves S, Alvarez A, Costa e Silva Z, et al. Acute kidney injury in intensive care unit patients: a comparison between the RIFLE and the Acute Kidney Injury Network classifications. Crit Care. 2008;12(4): R110.
• 9. Erel O, Neselioglu S. A novel and automated assay for thiol/ disulfide homeostasis. Clin Biochem 2014; 47:326-32.
• 10. Sen CK, Packer L. Thiol homeostasis and supplements in physical exercise. Am J Clin Nutr 2000; 72:653–69
• 11. Gumusyayla S, Vural G, Bektas H, Deniz O, Neselioglu S, Erel O. A novel oxidative stress marker in patients with Alzheimer’s disease: dynamic thiol-disulphide homeostasis. Acta Neuropsychiatr 2016; 28(6):315–20.
• 12. Sanri US, Özsin KK, Toktas F, Balci AB, Ustundag Y, Huysal K, et al. The effect of thiol-disulfide homeostasis in patients undergoing on-pump coronary artery bypass grafting. Turk Gogus Kalp Dama 2019; 27(4):484-492
• 13. Ozgunay SE, Ozsin KK, Ustundag Y, Karasu D, Ozyaprak B, Balcı B, et al. The Effect of Continuous Ventilation on Thiol-Disulphide Homeostasis and Albumin Adjusted Ischemia-Modifed Albumin During Cardiopulmonary Bypass. Braz J Cardiovasc Surg 2019; 34(4):436-43
• 14. Altiparmak IH, Erkus ME, Sezen H, Demirbag R, Gunebakmaz O, Kaya Z, et al. The relation of serum thiol levels and thiol/disulphide homeostasis with the severity of coronary artery disease. Kardiol Pol. 2016;74(11):1346-53
• 15. Qian X, Fang J, Zhu Q, Ma S, Wang W, Zheng Y, et al. Serum Protein Thiol Levels in Patients with Hospital-Acquired Acute Kidney Injury. Kidney Blood Press Res 2015; 40:623-629
• 16. Korkmaz A, Ozyazgan B, Kosem A, Elalmıs OU, Guray U, Ileri M, et al. The role of thiol levels in predicting contrast-induced nephropathy in patients with ST-segment elevation myocardial infarction who underwent primary percutaneous coronary intervention. North Clin Istanb 2019; 6(3):210–218
• 17. Gaffney AM, Sladen RN. Acute kidney injury in cardiac surgery. Curr Opin Anaesthesiol. 2015; 28(1):50-9
• 18. Ramos KA, Dias CB. Acute Kidney Injury after Cardiac Surgery in Patients Without Chronic Kidney Disease. Braz J Cardiovasc Surg 2018; 33(5):454-61
• 19. Del Duca D, Iqbal S, Rahme E, Goldberg P, de Varennes B. Renal failure after cardiac surgery: timing of cardiac catheterization and other perioperative risk factors. Ann Thorac Surg 2007; 84:1264-71.
• 20. Ranucci M, Ballotta A, Agnelli B, Frigiola A, Menicanti L, Castelvecchio S. Acute kidney injury in patients undergoing cardiac surgery and coronary angiography on the same day. Ann Thorac Surg 2013; 95:513-9