diplomska naloga
Nina Cirkvenčič (Avtor), Aleš Obreza (Mentor), Rok Frlan (Komentor)

Povzetek

After coronary artery bypass grafting, which are the most common types of cardiac surgery, develops acute renal injury requiring replacement therapy in 1–5 %. They are associated with high rates of morbidity and mortality. For this relevant clinical problem, it is recommended to monitor renal function after surgery. Standard parameters for investigating renal function in clinical routine are serum creatinine, measured creatinine clearance and in present time a prediction equation to estimate glomerular filtration rate (GFR) from serum creatinine by the MDRD study equation, but they all are based on measurement of serum creatinine, which is influenced by a lot of factors such as formation and excretion of creatinine and method of determination. In our study we included also a new marker of renal function serum cystatin C and predicted estimate GFR from serum cystatin C. We performed a prospective and partly randomized trial in 50 patients, half of the patients were operated on coronary arteries with cardiopulmonary bypass and the other half of patients were operated without cardiopulmonary bypass. Renal function was assessed 5 consecutive days; from preoperative day up to third postoperative day. Both patients groups were similar preoperatively, except they had different number of coronary arteries affected. During and after surgery there were no serious complications like myocardial infarct or death. No patients required postoperative dialysis support. Four patients, which are 8 % of all patients included in the study, developed acute renal injury class Risk for injury by RIFLE classification. Two of them were operated with cardiopulmonary bypass and two without it. Patients operated with cardiopulmonary bypass developed statistically significant but subclinical reduced GFR. Patients operated without cardiopulmonary bypass had stable GFR after surgery and uninjured renal function. Reduced renal function (GFR) after surgery with cardiopulmonary bypass we demonstrated with serum creatinine, cystatin C and calculated estimation of GFR from both serum markers. Measured creatinine clearances were unreliable, mainly because of imprecise collecting of timed urine samples and they also overestimate GFR, because creatinine is also secreted in urine by renal tubules.

Ključne besede

Mur encimi;inhibitorji;inhibitorji encima MurC;inhibitorji encima MurD;sinteza;protimikrobne učinkovine;

Podatki

Jezik: Slovenski jezik
Leto izida:
Tipologija: 2.11 - Diplomsko delo
Organizacija: UL FFA - Fakulteta za farmacijo
Založnik: [Cirkvenčič N.]
UDK: 542.057:543
COBISS: 2335089 Povezava se bo odprla v novem oknu
Št. ogledov: 424
Št. prenosov: 68
Ocena: 0 (0 glasov)
Metapodatki: JSON JSON-RDF JSON-LD TURTLE N-TRIPLES XML RDFA MICRODATA DC-XML DC-RDF RDF

Ostali podatki

Sekundarni jezik: Angleški jezik
Sekundarni naslov: Design and synthesis of 2-amino-2-oxoethyl-N-(arylsulphonil)carbamates as MurC and MurD inhibitors
Sekundarni povzetek: After coronary artery bypass grafting, which are the most common types of cardiac surgery, develops acute renal injury requiring replacement therapy in 1–5 %. They are associated with high rates of morbidity and mortality. For this relevant clinical problem, it is recommended to monitor renal function after surgery. Standard parameters for investigating renal function in clinical routine are serum creatinine, measured creatinine clearance and in present time a prediction equation to estimate glomerular filtration rate (GFR) from serum creatinine by the MDRD study equation, but they all are based on measurement of serum creatinine, which is influenced by a lot of factors such as formation and excretion of creatinine and method of determination. In our study we included also a new marker of renal function serum cystatin C and predicted estimate GFR from serum cystatin C. We performed a prospective and partly randomized trial in 50 patients, half of the patients were operated on coronary arteries with cardiopulmonary bypass and the other half of patients were operated without cardiopulmonary bypass. Renal function was assessed 5 consecutive days; from preoperative day up to third postoperative day. Both patients groups were similar preoperatively, except they had different number of coronary arteries affected. During and after surgery there were no serious complications like myocardial infarct or death. No patients required postoperative dialysis support. Four patients, which are 8 % of all patients included in the study, developed acute renal injury class Risk for injury by RIFLE classification. Two of them were operated with cardiopulmonary bypass and two without it. Patients operated with cardiopulmonary bypass developed statistically significant but subclinical reduced GFR. Patients operated without cardiopulmonary bypass had stable GFR after surgery and uninjured renal function. Reduced renal function (GFR) after surgery with cardiopulmonary bypass we demonstrated with serum creatinine, cystatin C and calculated estimation of GFR from both serum markers. Measured creatinine clearances were unreliable, mainly because of imprecise collecting of timed urine samples and they also overestimate GFR, because creatinine is also secreted in urine by renal tubules.
Vrsta dela (COBISS): Diplomsko delo
Strani: 78 f.
ID: 12061577