Correlation of C Reactive protein with acute kidney injury after coronary artery bypass grafting.

Abstract

Objective: To determine the correlation of preoperative CRP level with cardiac surgery associated AKI, morbidity and mortality after CABG Surgery. Study Design: Prospective Comparative study. Setting: Department of Cardiac Surgery, Faisalabad Institute of Cardiology, Faisalabad. Period: January 2023 to December 2023. Methods: After approval from the Ethical Review Committee, informed consent from patients was taken and they were included in this study. Patients were interviewed, explained and counseled about the procedure of the study. Routine Investigations including CRP levels were performed. Patients were divided into 2 groups as Group A (with Raised CRP (More than 5.0mg/L) and Group B (with Normal CRP (Less than 5.0mg/L) and CABG was performed. Post-operative outcomes in term of serum creatinine levels, length of ICU and hospital stay and mortality in early post-operative period was recorded and compared between the two groups. Results: Mean age was determined as 56.01 ± 7.07 years in Group A and 54.66 ± 7.3 (p<0.001) in Group B. Mean CRP of the population at the time of admission was determined as 6.8 ± 0.97 mg/L in Group A and 2.70 ± 0.97 (p<0.001) in Group B. Mean of baseline serum creatinine was determined as 1.107 ± 0.04 in Group A as compared to 1.199 ± 0.03 in Group B (p<0.001). Mean of peak serum creatinine were observed which were same as the values on the first day i.e., 1.39 ± 0.028 in Group A and 1.31 ± 0.030 in Group B. A significant correlation (p<0.001) was found in higher CRP levels and higher incidence of AKI in Group A and AKI was lower in case of group B. Chi-square test was used to determine that the incidence of AKI was greater in males in both groups as compared to females. Moreover, patients were distributed based on the follow-up treatments and outcomes, they received, and it was observed that majority of patients suffered AKI followed by medication, dialysis and death respectively in case of both Groups A and B. Conclusion: Conclusively, it can be stated that CRP levels at presentation are a direct predictor of acute kidney injury in the Pakistani local population especially in case of patients undergoing CABG. This is supported by evidence of increased serum creatinine levels with time, low urine output etc. in the patients with elevated CRP levels.