Does elevated urinary Dkkopf-3 level predict vulnerability to kidney injury during cardiac surgery?

Acute kidney injury (AKI) occurs in approximately one quarter of patients undergoing cardiac surgery and is associated with increased short-term and long-term mortality, as well as prolonged time for mechanical ventilation, intensive care, and hospitalization (1,2). AKI is defined by a sudden decrease in glomerular filtration rate typically with reduced urine output over a time period of hours to days; many patients with AKI also require renal replacement therapy (RRT) including hemodialysis or continuous RRT.