The Significance Of Early Detection Of KIM-1 To The Protection Of Alprostadil In The Acute Kidney Injury After The Cardiac Valve Replacement Surgery

Objective To discuss the significance of a new AKI indicator in early postoperative patients of valve replacement by test the KIM-1 concentration of blood and urine,and use this new indicator to evaluate the protection of Alprostadil on acute kidney injury(AKI) after the single cardiac valve replacement surgery.Methods We choose 100 patients who need to receive cardiac valve replacement on cardiopulmonary bypass(CPB) from the Department of Cardiac Surgery of the First affiliated Hospital of Anhui Medical University from June 2013 to February 2015.These patients were randomly divided into control group and the experimental group,and each group with 50 patients,all patients were treated with conventional therapy before operation.Meanwhile,the experimental group patients were pumped with Alprostadil from central vena at the speed of 5ng/kg.min from 30 min before CPB to the end of CPB.Collect the blood and urine specimens of two groups during the preoperative(30min before CPB)(T0),after CPB 2h(T1), 6h(T2), 12h(T3), 24h(T4), 48h(T5) and detect the content of serum creatinine and KIM-1 of blood and urine.The above two groups were divided into four subgroups according to whether meet the diagnosis of AKI,recorded as:control-non AKI subgroup,control-AKI subgroup, experiment-non AKI subgroup and experimental-AKI subgroup, comparison of changes in the patient index in each group.Results 1.Control-non AKI subgroup and the control-AKI subgroup:Scr values of time point T0-T4 were no statistically significance(P<0.05),T5 timepoint was statistically significance,both blood and urine KIM-1 values at T0 time point and T1 time point were no significant difference(P>0.05), while there were statistical differences at T2-T5 time points(P<0.05);2. Experiment- non AKI subgroup and experimental-AKI subgroup: Scr values of time point T0-T4 were no statistically significance(P<0.05),T5 time point was statistically significance,both blood and urine KIM-1 values at T0 time point and T1 time point were no significant difference(P>0.05), while there were statistical differences at T2-T5 time points(P<0.05);3. The number of patients in the experimental group of postoperative AKI significantly less than the control one.Conclusion KIM-1 can be used as a new marker in the early diagnosis of AKI after heart valve replacement,the level changes earlier than creatinine and can be used to the early diagnosis and prognosis of AKI;Alprostadil has a certain protective effect on acute kidney injury after valve replacement by CPB.