Our Summary

This research paper investigates whether a specific ratio in the blood, known as the neutrophil to lymphocyte ratio (NLR), can predict the risk of acute kidney injury (AKI) after a certain type of heart surgery (on-pump coronary artery bypass).

The researchers looked at 154 patients who had this heart surgery. They found that the patients who experienced acute kidney injury after the surgery had a higher NLR before the operation, compared to those who didn’t have kidney injury. They also had higher levels of a substance called creatinine in their blood, and their surgery took longer.

When they grouped the patients based on their NLR levels, they found that those with higher NLR were more likely to have kidney injury after surgery.

The researchers concluded that a higher NLR before surgery is linked to a greater risk of acute kidney injury after on-pump coronary artery bypass surgery. This finding was independent of other known risk factors. Therefore, measuring NLR before surgery could help predict the risk of post-surgery kidney injury.

FAQs

  1. What is the neutrophil to lymphocyte ratio (NLR) and how does it relate to the risk of acute kidney injury after heart surgery?
  2. How did higher NLR levels affect the likelihood of kidney injury after on-pump coronary artery bypass surgery?
  3. Can measuring NLR before surgery help predict the risk of kidney injury post-surgery?

Doctor’s Tip

A helpful tip a doctor might tell a patient about heart bypass surgery is to monitor and manage their pre-surgery neutrophil to lymphocyte ratio (NLR) as it can be an indicator of potential post-surgery complications, such as acute kidney injury. By keeping this ratio in check, patients may be able to reduce their risk of experiencing complications during their recovery process.

Suitable For

Patients who are typically recommended for heart bypass surgery are those who have severe coronary artery disease that cannot be managed with medications or less invasive procedures such as angioplasty. These patients may have symptoms such as chest pain (angina), shortness of breath, or heart failure due to blocked or narrowed arteries in the heart.

Additionally, patients who are at high risk for a heart attack or other serious complications due to their coronary artery disease may also be recommended for heart bypass surgery. This can include patients with multiple blockages in their coronary arteries, diabetes, or a history of heart attacks.

In the case of the research paper mentioned above, patients who are undergoing on-pump coronary artery bypass surgery and have a higher neutrophil to lymphocyte ratio (NLR) before the operation may be at a greater risk for developing acute kidney injury after the surgery. Monitoring NLR levels before surgery could help identify these high-risk patients and potentially take steps to prevent or minimize the risk of kidney injury.

Timeline

Before heart bypass surgery:

  1. Patient undergoes various tests to assess their overall health and the condition of their heart, including blood tests, electrocardiogram, echocardiogram, and stress test.
  2. Patient may need to make lifestyle changes, such as quitting smoking, adjusting diet, and increasing physical activity, to improve their health before surgery.
  3. Patient meets with their healthcare team to discuss the procedure, potential risks, and expected outcomes.

After heart bypass surgery:

  1. Patient is closely monitored in the intensive care unit immediately after surgery to ensure they are stable and recovering well.
  2. Patient is gradually moved to a regular hospital room once they are stable and their condition improves.
  3. Patient undergoes physical therapy and rehabilitation to regain strength and mobility.
  4. Patient may need to make long-term lifestyle changes, such as taking medications, attending cardiac rehabilitation, and following a heart-healthy diet, to prevent future heart issues.
  5. Patient follows up with their healthcare team regularly to monitor their progress and adjust their treatment plan as needed.

What to Ask Your Doctor

  1. What is the purpose of a heart bypass surgery?
  2. What are the potential risks and complications associated with heart bypass surgery?
  3. How long is the recovery process after heart bypass surgery?
  4. How will my quality of life be impacted after heart bypass surgery?
  5. Are there any alternative treatment options to heart bypass surgery?
  6. How can I best prepare for heart bypass surgery?
  7. What is the success rate of heart bypass surgery?
  8. Will I need to make any lifestyle changes after heart bypass surgery?
  9. How often will I need to follow up with my doctor after heart bypass surgery?
  10. Will I need to take any medications after heart bypass surgery?

Reference

Authors: Guangqing Z, Liwei C, Fei L, Jianshe Z, Guang Z, Yan Z, Jianjun C, Ming T, Hao C, Wei L. Journal: Gen Thorac Cardiovasc Surg. 2022 Jul;70(7):624-633. doi: 10.1007/s11748-022-01772-z. Epub 2022 Feb 1. PMID: 35103920