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Evaluation of highly damaged renal function following extracorporeal circulation —Usefulness of alpha 1-microglobulin index—

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Abstract

The patients with highly damaged renal functions following extracorporeal circulation (ECC) were reviewed. Markers such as serum and urine creatinine (SCr, UCr), blood urea nitrogen (BUN), alpha 1-microglobulin in urine (as a marker of renal tubular function, abbreviated as Uα1-m), microalbumin in urine (as a marker of renal glomerular function, abbreviated as UA1b) were measured in each cases. Twenty patients were selected with the maximum value of Uα1-mover 60 μg/dl during or after ECC. The patients were classified into three groups according to preoperative value of α1-m index (α1-m index (I)=Uα1-m/UCr × 100 mg/g Cr), and Albumin index (Albumin index (I)=UA1b/UCr × 100 mg/g Cr). Group I (n=13); α1-m I>10 and, A1b I≧50 (abnormal value of tubular and glomerular function), Group II (n=3); α1-m I≦10, A1b I≧50 (abnormal value of glomerular function), Group III (n=4); α1-m I≦10, A1b I<50 (normal value of tubular and glomerular function). Six patients in Group I required postoperative hemodialysis (HD) and one patient in Group II. No one required HD in Group III. These facts suggest that preoperative damage of tubular and glomerular functions may become prolonged or irreversible damages may occur after operation. HD is required frequently in patients with α1-m I level over 500 mg/g Cr, especially continuous HD may be needed in patient with α1-m I level over 1000 mg/g Cr.

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Authors and Affiliations

  1. First Department of Surgery, Showa University School of Medicine, Tokyo, Japan

    Takashi Narisawa, Atsubumi Murakami, Masahiro Aiba & Toshihiro Takaba

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  1. Takashi Narisawa
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  2. Atsubumi Murakami
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  3. Masahiro Aiba
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  4. Toshihiro Takaba
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Narisawa, T., Murakami, A., Aiba, M. et al. Evaluation of highly damaged renal function following extracorporeal circulation —Usefulness of alpha 1-microglobulin index—. Jpn J Thorac Caridovasc Surg 46, 1097–1104 (1998). https://doi.org/10.1007/BF03217883

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  • DOI: https://doi.org/10.1007/BF03217883

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