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Medicinski pregled
2020, vol. 73, br. 1-2, str. 5-12
jezik rada: engleski
vrsta rada: izvorni naučni članak
objavljeno: 20/06/2020
doi: 10.2298/MPNS2002005G
Preoperativne vrednosti hemoglobina i mokraćne kiseline kao faktori rizika za akutno oštećenje bubrega kod kardiohirurških pacijenata
aUniverzitet u Novom Sadu, Medicinski fakultet + Univerzitet u Novom Sadu, Medicinski fakultet, Institut za kardiovaskularne bolesti
bUniverzitet u Novom Sadu, Medicinski fakultet, Institut za kardiovaskularne bolesti
cUniverzitet u Novom Sadu, Medicinski fakultet

e-adresa: andrej.preveden@mf.uns.ac.rs

Sažetak

Uvod. Akutno oštećenje bubrega udruženo sa kardiohirurškom operacijom česta je i značajna postoperativna komplikacija i sa učestalošću 9 ̶ 39%, prema različitim studijama, predstavlja drugi najčešći uzrok akutnog zatajivanja bubrega u jedinicama intenzivne nege i nezavisan prediktor mortaliteta. Cilj ovog rada bio je da se ispita značaj preoperativnih vrednosti hemoglobina i mokraćne kiseline kao faktora rizika za razvoj akutnog oštećenja bubrega u postoperativnom periodu kod kardiohirurških pacijenata. Materijal i metode. Istraživanjem je obuhvaćeno ukupno 118 pacijenata, koji su podeljeni u dve grupe. Prvu grupu činilo je 59 pacijenata koji su razvili akutno oštećenje bubrega i koji su zahtevali terapiju zamene bubrežne funkcije, a drugu grupu je činilo 59 pacijenata bez akutnog oštećenja bubrega. Tipovi hirurgije bili su koronarna, valvularna, kombinovana, disekcija aorte i druge. Svi potrebni podaci o pacijentima su uzeti iz medicinske dokumentacije i iz elektronske medicinske baze podataka. Rezultati. Pronađena je statistički značajna razlika između grupa u odnosu na vrednosti preoperativnog hemoglobina (108 vs 143 g/l, p = 0,0005); postoperativnih vrednosti uree (26,4 vs 5,8 mmol/l, p = 0,0005) i kreatinina (371 vs 95 mmol/l, p = 0,0005), reaktanata akutne faze zapaljenja - C-reaktivni protein (119,4 vs 78,9 mg/l, p = 0,002) i prokalcitonina (7 vs 0,2 ng/ml, p = 0,0005), izoenzima CK-MB (1045 vs 647 mg/l, p = 0,014); kao i u vremenskom trajanju ekstrakorporalne cirkulacije (103,5 vs 760 min, p = 0,0005) i kleme ascendentne aorte (89 vs 67 min, p = 0,0005) tokom kardiohirurške operacije. Izuzetak su preoperativne vrednosti mokraćne kiseline, gde između ispitivanih grupa nije pronađena statistički značajna razlika (382 vs 364 mmol/l, p = 0,068). Otkrivena je statistički značajna korelacija između upotrebe inotropnih lekova i razvoja akutnog oštećenja bubrega. Zaključak. Postoji visok stepen korelacije između preoperativnih niskih vrednosti hemoglobina i posleoperativne pojave akutnog oštećenja bubrega. Ne postoji statistički značajna korelacija između preoperativnih vrednosti mokraćne kiseline i posleoperativne pojave akutnog oštećenja bubrega.

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