Preoperative blood morphology and incidence of acute kidney injury after on-pump coronary artery bypass grafting – a single-center preliminary report

INTRODUCTION: Acute kidney injury (AKI) after coronary artery bypass grafting (CABG) performed in cardiopulmonary bypass (CPB) may complicate the postoperative course and has a negative impact on outcome. In some cases, postoperative AKI develops in spite of normal baseline creatinine concentration and estimated glomerular filtration rate (eGFR). AIM: To examine whether there is any association between the preoperative blood morphology and incidence of post-operative AKI. MATERIAL AND METHODS: The study involved 62 consecutive patients with the mean age of 64.0 ±7.4 years who underwent CABG in CPB. Before surgery, blood morphology and biochemistry were analyzed. Patients with eGFR below 60 ml/min/1.73 m(2) were excluded. After the operation, parameters of renal function were checked systematically. Acute kidney injury was defined according to the Acute Kidney Injury Network (AKIN) classification. RESULTS: Twenty-one (33.9%) patients presented AKI (group AKI), although in the majority of them (n = 16) it was temporary and medical management was enough to cure AKI. Only in 1 (1.6%) case was renal replacement therapy necessary. In group AKI, patients’ preoperative hemoglobin concentration (8.46 ±0.72 mM/l), red blood cell count (4.51 ±0.39 × 10(12)/l) and hematocrit (0.40 ±0.04) were significantly lower (p < 0.05) than in group C (9.07 ±0.57 mM/l; 4.78 ±0.36 × 10(12)/l; 0.43 ±0.03, respectively). Interestingly, the baseline parameters of renal function were comparable between groups. CONCLUSIONS: Hemoglobin concentration and red blood cell counts close to the lower limit of the normal range may enable identification of patients at risk of AKI early after CABG in CPB among individuals with normal preoperative biochemical parameters of renal function.