Določanje novih bioloških označevalcev v vzorcih urina bolnikov z akutno ledvično okvaro, po prestani operaciji na srcu

Plavec, Jana (author), Skitek, Milan (mentor), Jerin, Aleš (comentor)

Akutna okvara ledvic AOL je pogost, a še vedno relativno slabo prepoznan sindrom. Približno ena tretjina vseh bolnikov po operaciji srca razvije AOL. Glede na to, da AOL ne označujejo določeni simptomi za postavljanje diagnoze AOL se uporablja kreatinin katerega se zaradi njegovega poznega odgovora poskuša zamenjati z zgodnjimi in bolj občutljivimi biološkimi označevalci. Namen magistrske naloge je bil odkriti zgodnjo AOL po operaciji srca z določanjem koncentracij novih bioloških označevalcev, kot sta BHMT-2 in IL-18 v urinskih vzorcih z ELISA tehnologijo. Predvidevali smo, da bodo te koncentracije pri pacientih, ki so razvili AOL, drugačne kot pri tistih pacientih, pri katerih se AOL ni razvila. V raziskavo so bili vključeni pacienti, ki so bili predstavljeni za operacijo srca z uporabo zunajtelesnega krvnega obtoka. Pacientom so pred in med operacijo ter po njej bili odvzeti serumski in urinski vzorci. Po operaciji smo paciente na podlagi serumske koncentracije kreatinina razdelili v dve skupini, oziroma na tiste, ki so razvili AOL in na tiste, ki je niso. V raziskavi nam ni uspelo BHMT-2 ovrednotiti kot zgodnjega označevalca AOL. V nasprotju z našimi pričakovanji se njegova koncentracija po operaciji bistveno zmanjšuje. Po drugi strani pa smo ugotovili, da ima IL-18 potencialno vlogo pri zgodnjem odkrivanju AOL bolnikov po operaciji srca. Njegova koncentracija po operaciji je približno 5-krat večja v primerjavi s predoperativno koncentracijo. Toda njegova prediktivna natančnost za AOL se precej razlikuje. Potrebna so nadaljnja raziskovanja, da bi se uporaba teh označevalcev potrdila kot klinična metoda za zgodnje odkrivanje bolnikov z AOL.

• Language: Slovenian
• Keywords: akutna okvara ledvic, novi biološki označevalci, BHMT-2, IL-18
• Work type: Master's thesis/paper
• Organization: FFA - Faculty of Pharmacy
• Year: 2020
• PID: 20.500.12556/RUL-114472
• Publication date in RUL: 29.02.2020

Secondary language

• Language: English
• Title: Determination of new biomarkers in urine samples obtained after cardiac surgery of patients with acute kidney failure

Abstract

Acute kidney injury AKI is a common but still relatively poorly recognized syndrome. About one-third of all patients develop AKI after cardiac surgery. Given that AKI is not characterized by certain symptoms for the diagnosis of AKI, creatinine is used which, due to its late response, is being attempted to be replaced by earlier and more sensitive biomarkers. The purpose of the masters thesis was to detect early AKI after cardiac surgery by determining concentrations of new biomarkers such as BHMT-2 and IL-18 in urine samples using ELISA technology. These concentrations were predicted to be different in patients who developed AKI than in those patients who did not develop AKI. The study included patients with ischemic heart disease presented for cardiac surgery with cardiopulmonary bypass. Serum and urine samples were taken before and after surgery After surgery, patients were divided into two groups based on serum creatinine concentration, to those who developed AKI and to those who did not. The study failed to evaluate BHMT-2 as an early marker of AKI. Contrary to our expectations, his concentration decreases significantly after surgery. On the other hand, we found that IL-18 has a potential role in the early detection of AKI in patients after cardiac surgery. Its concentration after surgery is approximately 5 times higher than the preoperative concentration. But its predictive accuracy for AKI is quite different. Further studies are needed to confirm the use of these biomarkers as a clinical method for the early detection of AKI.

• Keywords: acute kidney injury, new biomarkers, BHMT-2, IL-18