eComment. Creatinine in the diagnosis of acute kidney injury following cardiac surgery with cardiopulmonary bypass

Abstract

We read the article by Takaki et al. [1] with great interest, owing to the fact that the onset of kidney failure in the postoperative period following cardiac surgery is, perhaps, the most common complication and one that is linked to high morbidity and mortality and increased hospital stays, both in the ICU and generally; it is an independent predictor of mortality following cardiac surgery [2,3].

Several authors have highlighted the role of creatinine as a predictive factor in the development of acute kidney injury (AKI). The majority of studies are based on the analysis of raised creatinine levels, and do not take into account reductions to the figures due to haemodilution, a consequence of the priming of extracorporeal circulation (ECC). In this sense, the analysis of these authors is very interesting, as it looks at the correlation between changes in creatinine levels and haematocrit [1]. The issue of optimum haematocrit levels that should be maintained during ECC in order to reduce the incidence of AKI is widely debated