Serum creatinine role in predicting outcome after cardiac surgery beyond acute kidney injury

Abstract

Serum creatinine is still the most important determinant in the assessment of perioperative renal function and in the prediction of adverse outcome in cardiac surgery. Many biomarkers have been studied to date; still, there is no surrogate for serum creatinine measurement in clinical practice because it is feasible and inexpensive. High levels of serum creatinine and its equivalents have been the most important preoperative risk factor for postoperative renal injury. Moreover, creatinine is the mainstay in predicting risk models and risk factor reduction has enhanced its importance in outcome prediction. The future perspective is the development of new definitions and novel tools for the early diagnosis of acute kidney injury largely based on serum creatinine and a panel of novel biomarkers.

Keywords: Creatinine; Acute kidney injury; Cardiac surgery; Outcome; Biomarker

Core tip: This manuscript aims to review the latest achievements in the diagnosis and treatment of acute kidney injury (AKI). Despite much progress in recent years, especially in the development of novel biomarkers, serum creatinine still plays the major role. Creatinine is not only the mainstay of definition, diagnosis and prediction of AKI, but also the most important predictor of outcome after cardiac surgery, including mortality and morbidity as well as hospital length of stay.