Vloga proteinov Klotho in CYR61 pri zgodnjem odkrivanju akutne poškodbe ledvic po operaciji srcaMosa Fathy, Osama (Avtor) Skitek, Milan (Mentor) Jerin, Aleš (Komentor) Acute kidney injury (AKI) is a critical problem accompanied with cardiac surgery as one of the adverse complications that contribute to prolonged hospitalization period and/or increase morbidity and mortality rates, surpassing 40% among cardiac ICU patients. Cardiac surgery with cardiopulmonary bypass (CPB) reproduces globally every year leading to volume depletion as a result of cardiac output exhaustion and stimulation of renin-angiotensin system with renal vasoconstriction that increases the extent of AKI among hospitalized patients. It is well known that AKI may worsen kidney function by time depending on slowly traditional biomarker “serum creatinine” which tardily increases after 2 days of renal tubular injury indicating that 50% of kidney function is lost and creatinine kinetics is influenced by ethnicity, gender, age, dietary protein intake, muscle mass and medications that didn’t reflect precisely the prognosis of AKI over time. Therefore, the needs for novel biomarkers are important situations to improve sensitivity, specificity of clinical diagnosis and potentiate the efficiency of treatment to prevent irreversible consequences. In the present doctoral work, the following hypotheses will be tested: 1) Plasma/serum or urinary levels of Klotho and CYR61 are early prognostic biomarkers of AKI after cardiac surgery. 2) Klotho and CYR61 are markers of renal tubular dysfunction at the different levels of AKI after cardiac surgery. 3) The combinations of Klotho and CYR61 with other markers (f.e. NGAL/Klotho or KIM-1/Klotho ratios) will increase the prognostic efficiency of AKI after cardiac surgery. Our study covered 50 patients admitted to cardiac surgery department in the University Medical Center Ljubljana and fulfilled the inclusion criteria of selection. The classification of patients into AKI group and non-AKI group relies on KDIGO (Kidney Disease Improving Global Outcomes) that declared its validation for AKI staging and severity in the recent ADAQI consensus, retained almost advantages of both RIFLE and AKIN criteria in a harmonized manner. Serum levels of creatinine, cystatin C, CYR61 and klotho were measured at five time intervals before and within 48 hours of CPB.[O. Mosa]20162023-01-12 07:47:16Doktorska disertacija143777sl