Enzyme Biomarkers of Renal Tubular Injury in Arterial Surgery Patients

Abstract

Objective: The aim of this study was to verify whether preoperative diabetes, hypertension, and renal function had any relationship with postoperative tubule function in patients submitted to anesthesia for arterial surgery. Methods: Prospective observational study. One hundred and forty-four patients submitted to anesthesia for arterial surgery enrolled consecutively and divided into four groups: G1 - diabetes and hypertension; G2 - diabetes; G3 - hypertension; and G4 - without hypertension or diabetes. Urine was obtained for laboratory analysis of urinary creatinine (Ucr), alkaline phosphatase (AP), gamma-glutamyltransferase (gamma GT), and blood for cystatin C and creatinine before the surgery (M1) and 24 h after the surgery (M2). Results: Values of gamma GT, gamma GT/Ucr, and AP x gamma GT/Ucr increased at M2 in G4. Patients without renal function compromise (GFR >= 90 mL/min/1.73 m(2)) presented increased gamma GT/Ucr and AP x gamma GT/Ucr values at M2 and those with slightly compromised renal function (60-89 mL/min/1.73 m(2)) presented increased gamma GT values at M2. There was no correlation between deltaCystatin C and deltaAP, delta gamma GT, delta gamma GT/Ucr, deltaAP/Ucr, and deltaAP x gamma GT/Ucr. Conclusions: Diabetes, hypertension, and preoperative renal function seem to interfere in tubular enzymuria immediately after surgery in arteriopathic patients. However, when these markers do not increase in postoperative period, renal dysfunction cannot be discarded.