Key result
Baseline diabetes, hypertension, and renal function interfere with postoperative enzymuria, masking potential renal dysfunction.
Why the study?
The relationship between preoperative diabetes, hypertension, renal function, and postoperative renal tubular function in arterial surgery patients was unclear.
Do preoperative diabetes, hypertension, and renal function affect postoperative tubule function in patients undergoing arterial surgery?
Observational (n=144)
Do preoperative diabetes, hypertension, and renal function affect postoperative tubule function in patients undergoing arterial surgery?
Preoperative diabetes, hypertension, and renal function appear to influence tubular enzymuria immediately after arterial surgery, though the absence of biomarker elevation does not rule out renal dysfunction.
Preoperative diabetes, hypertension, or reduced GFR may blunt early tubular enzymuria after arterial surgery; leaves open prognostic value of these markers.
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), γ-glutamyltransferase (γGT), and blood for cystatin C and creatinine before the surgery (M1) and 24 h after the surgery (M2). RESULTS: Values of γGT, γGT/Ucr, and AP × γGT/Ucr increased at M2 in G4. Patients without renal function compromise (GFR ≥90 mL/min/1.73 m(2)) presented increased γGT/Ucr and AP × γGT/Ucr values at M2 and those with slightly compromised renal function (60-89 mL/min/1.73 m(2)) presented increased γGT values at M2. There was no correlation between deltaCystatin C and deltaAP, deltaγGT, deltaγGT/Ucr, deltaAP/Ucr, and deltaAP × γGT/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.
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Silva et al. (2011) conducted an observational in Arterial surgery (n=144). Preoperative diabetes and hypertension vs. Patients without hypertension or diabetes was evaluated on Postoperative tubule function (urinary enzymes including γGT and AP). Preoperative diabetes, hypertension, and renal function interfere with tubular enzymuria immediately after arterial surgery, but lack of marker increase does not rule out renal dysfunction.
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