Key result
Moderate surgical stress significantly increased lithium clearance rates (from 19.7 to 31.7 mL/min/100 kg, p<0.01) and NAG enzymuria, indicating early postoperative renal tubular dysfunction.
Why the study?
Does moderate surgical stress alter glomerulotubular function in patients?
Observational (n=16)
Does moderate surgical stress alter glomerulotubular function in patients?
Moderate surgical stress causes early postoperative renal tubular dysfunction that is not detected by conventional serum creatinine screening.
Answers are grounded in this paper and cite their sources.
May signal subclinical tubular injury missed by creatinine after moderate surgery; leaves open need for prospective validation of tubular markers.
Glomerular function and renal tubular function assessed by measurements of creatinine clearance rates (CCR), lithium clearance rates (CLi, and N-acetyl-beta-D-glucosaminidase (NAG) enzymuria were measured immediately prior to and within 24 h of operation (average operative time 150 min) in 16 patients undergoing a moderate surgical stress. Although serum creatinine concentrations and CCR were similar pre- and postsurgery at 105 +/- 21 and 108 +/- 21 mumol/L and 108 +/- 67 and 110 +/- 59 mL/min/100 kg body weight (mean +/- SD), respectively, both CLi and NAG were significantly increased following the surgical insult. CLi was increased from 19.7 +/- 6.1 to 31.7 +/- 16.7 mL/min/100 kg (p less than 0.01) and NAG from 71 +/- 58 to 164 +/- 10 U/mmol urinary creatinine (p less than 0.001). In addition, the absolute distal tubular reabsorption of sodium and water increased from 18.3 +/- 5.9 and 15.8 +/- 9.7 to 30.6 +/- 16.4 and 27.6 +/- 12.2 mL/min/100 kg body weight (both p less than 0.05), respectively. These results indicate early postoperative renal tubular dysfunction following a moderate surgical stress, undetected by conventional screening.
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Anderson et al. (1992) conducted an observational in Moderate surgical stress (n=16). Moderate surgical stress vs. Pre-surgery baseline was evaluated on Lithium clearance rates (CLi) (p=<0.01). Moderate surgical stress significantly increased lithium clearance rates (from 19.7 to 31.7 mL/min/100 kg, p<0.01) and NAG enzymuria, indicating early postoperative renal tubular dysfunction.
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