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The relationship between renal function and renal urodilatin excretion immediately after cardiac surgery

Introduction

The precise pathophysiological role of the natriuretic and diuretic peptide urodilatin remains to be defined. We hypothesized that there is a relationsship between renal function and the course of renal urodilatin excretion (UUROV) immediately after cardiac surgery (CS) and – specifically – that a lower UUROV may be observed in patients (pts) showing an increase in PCREA.

Methods

We determined UUROV, urine flow (UV), plasma creatinine (PCREA) and creatinine clearance (CLCREA) in 61 consecutive pts immediately after cardiac surgery. Blood samples were taken after arrival at the ICU (P0) and after 4–8 h (P1) and 12–16 h (P2) hours, urine was sampled from P0 to P1 and from P1 to P2, respectively. URO was measured with a commercially available RIA (Immundiagnostik, Germany). Pts were divided into subgroups showing an increase in PCREA of more than 25% (PCREA + group: n = 10) or not (PCREA ± group: n = 51).

Results

Baseline variables at P0 were not different between both groups. UUROV was tremendously increased in comparison with historical data from healthy volunteers and did not differ between both groups during the observation period despite a significant decrease of CLCREA in the PCREA + group (Table 1). Correlation analysis of all pts revealed a significant relationship between the decrease in CLCREA and the decrease in UUROV (r = 0.5, P = 0.006).

Table 1 Table 1

Conclusions

UUROV is tremendously increased immediately after cardiac surgery. The relationsship between the decrease in UUROV and CLCREA suggests that URO might play a role in the fluid homeostatic adaptions after cardiac surgery and cardiopulmonary bypass. However, pts showing an increase in PCrea and a decrease in CLCREA cannot be identified by a single determination of UUROV.

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Heringlake, M., Uhlig, T., Bahlmann, L. et al. The relationship between renal function and renal urodilatin excretion immediately after cardiac surgery. Crit Care 5, P219 (2001). https://doi.org/10.1186/cc1286

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Keywords

  • Public Health
  • Peptide
  • Blood Sample
  • Creatinine
  • Renal Function