| Outcome Measures: |
Primary: Incidence of AKI (%), Difference between groups in the incidence of AKI in patients with CKD are assessed as percentage after cardiac surgery according to KDIGO criteria., 7 days | Secondary: Incidence of low cardiac output syndrome (%), Difference between groups in the incidence of low cardiac output syndrome (decrease in the incidence of low cardiac output syndrome) with the definition of its type (with dysoxia, without dysoxia, microcirculatory distress). It is a combined point and includes an increase (or various combinations of these parameters according to the cardiovascular profile in shock) of serum lactate more than 2 mmol/L, a decrease in central venous blood saturation of less than 70%, an increase in the arterio-venous carbon dioxide difference of more than 6 mm Hg, and the need for intra-aortic balloon counterpulsation or other extracorporeal methods of circulatory support within 24 hours after surgery., 24 hours|Regional tissue oxygen saturation levels (rSO2, %), Difference between groups in regional kidney near-infrared oximetry (rSO2, %): before sternotomy, at the CPB, 6 hours and 24 hours after surgery., 24 hours|ΔPCO2/ΔContO2 (ratio), Difference between groups in terms of ΔPCO2/ΔContO2: before sternotomy, 6 hours and 24 hours after surgery., 24 hours|AKI Severity (degree), Difference between groups in severity of AKI as defined by the KDIGO guidelines: Stage 1 AKI is diagnosed when serum creatinine rises 1.5 to 1.9 times its baseline and preoperative values within seven days postoperatively, or when it rises ≥0.3 mg/dL (≥26.5 μm/l) within 48 hours after the intervention, and also if urine output is \<0.5 ml/kg/h for 6-12 hours in the first postoperative period. Stage 2 AKI is diagnosed when serum creatinine increases 2.0 to 2.9 times its preoperative baseline values within 7 days postoperatively and urine output is \<0.5 ml/kg/h more than 12 hours after surgery. Stage 3 AKI is diagnosed when serum creatinine rises 3 times its preoperative baseline values within seven days post-intervention, or when it rises to ≥ 4.0 mg/dl (≥ 353.6 μm/L) within 48 hours after the intervention, or if there is a need for renal replacement therapy, and also, if the urine output was \<0.3 ml / kg / h within 24 hours after surgery., 7 days|AKI duration (hours), Difference between groups in the duration of AKI: transient (less than 48 hours) and persistent., Seven days|Level of NO in exhaled air (ppm), Difference between groups in the level of NO in exhaled air at baseline, on admission to the ICU, 6 hours later and 24 hours after surgery., 1st day after operation|Renal replacement therapy need (%), Difference between groups in the frequency of need for renal replacement therapy during hospitalization., 14 days|Major adverse kidney events (%), Difference between groups in the frequency of major kidney complications during hospitalization. Major adverse kidney events (MAKE) are a composite endpoint and include death, new episodes of kidney replacement therapy, and deterioration in renal function (GFR decrease of 25% or more from baseline)., 30 days|Incidence of incomplete recovery of renal function (%), Difference between groups in the incidence of incomplete recovery of renal function (decrease in GFR by more than 10% compared with preoperative levels), or persistent renal dysfunction (defined as an increase in serum creatinine 1.5 times the baseline values or ≥0.5 mg / dL (44 µmol/L) compared with preoperative level) at discharge from the hospital., 30 days|Maximum severity of multiple organ failure (SOFA scale), Difference between groups in the level of organ dysfunction and mortality risk measured on a scale Sequential Organ Failure Assessment (SOFA) in the first 24 hours after surgery. Minimum score is 0, maximum score is 24. A higher score indicates an increased risk of mortality., 24 hours|Vasoactive-inotropic score (VIS), Difference between groups in the maximum requirement for inotropic and vasopressor drugs assessed as the vasoactive-inotropic score (VIS). VIS is calculated as follows: dose of dopamine (mcg/kg/min) + dose of dobutamine ( mcg/kg/min) + 100 x dose of epinephrine (mcg/kg/min) + 10 x dose of milrinone (mcg/kg/min) + 10,000 x dose of vasopressin (u/kg/min) + 100 x dose of norepinephrine (mcg /kg/min) + 10 × dose of phenylephrine (mcg/kg/min)., 24 hours|Duration of mechanical ventilation (hours), Difference between groups in the duration of mechanical ventilation (hours)., 21 days|ICU stay (days), Difference between groups in the length of ICU stay (days)., 30 days|Hospital stay (days), Difference between groups in the length of hospital stay (days)., 30 days|Hospital mortality (%), Difference between groups in hospital mortality rate., 14 days|30-day mortality rate (%), Difference between groups in mortality rate within 30 days after surgery., 30 days|Incidence of neurological complications of type 1 (stroke, transient ischemic attack, coma) (%), Difference between groups in the incidence of neurological complications of type 1 (stroke, transient ischemic attack, coma) during hospitalization., 14 days|Incidence of neurological complications of type 2 (delirium, early postoperative cognitive dysfunction, first-onset seizures) (%), Difference between groups in the incidence of neurological complications of type 2 (delirium, early postoperative cognitive dysfunction, first-onset seizures) during hospitalization., 14 days|Platelet count, Difference between groups in platelet counts 24 hours after surgery., 24 hours|Postoperative bleeding (mL), Difference between groups in the volume of postoperative bleeding, which is calculated as the total blood loss through drains during the stay in the ICU., 24 hours|Incidence of blood or blood component transfusion (%), Difference between groups in the frequency of blood transfusion or transfusion of blood components during the period of stay in the ICU., Seven days|Incidence of major adverse cardiac events (MACE) (%), Differences between groups in the incidence of major adverse cardiac events (MACE) during hospitalization and within 30 days after surgery. Major adverse cardiac events - combined endpoint: myocardial infarction, pacing requirement for \>48 hours, cardiac arrest., 30 days|Incidence of other postoperative complications (%), Differences between groups in the incidence of other postoperative complications (acute respiratory failure requiring noninvasive ventilation or reintubation, pneumonia, vasoplegia, wound infections, sepsis, readmission to the ICU) to be determined according to standard ESA/ESICM definitions where possible., 30 days | Other: Subclinical AKI, Differences between groups in the incidence of subclinical AKI according to the results of the study of biomarkers of kidney damage., 24 hours|Subclinical intestinal injury, Differences between groups in the incidence of subclinical intestinal injury according to the results of testing the intestinal injury biomarkers., 24 hours|Subclinical myocardial damage, Differences between groups in the frequency of subclinical myocardial damage according to the results of the study of biomarkers of myocardial damage., 24 hours
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