scholarly journals Urine complement activation fragments are increased in patients with kidney injury after cardiac surgery

2019 ◽  
Vol 317 (3) ◽  
pp. F650-F657 ◽  
Author(s):  
Jennifer Laskowski ◽  
Heather Thiessen Philbrook ◽  
Chirag R. Parikh ◽  
Joshua M. Thurman
Keyword(s):  
Acute Kidney Injury ◽  
Cardiac Surgery ◽  
Complement Activation ◽  
Alternative Pathway ◽  
Ischemia Reperfusion ◽  
Kidney Injury ◽  
Urine Biomarkers ◽  
Pathway Activation ◽  
Alternative Pathway Of Complement ◽  
Subsequent Rise

Experiments in mouse models have shown that the complement cascade is activated within the kidney after ischemia-reperfusion and that complement activation contributes to tubular injury in this setting. Less is known, however, about complement activation in human kidneys after ischemia or whether complement activation in the tubulointerstitium can be detected by measurement of complement fragments in the urine. We hypothesized that urine biomarkers of complement activation would rapidly increase in patients who develop ischemic acute kidney injury, signaling complement activation within the kidney. We confirmed that the alternative pathway of complement is activated in the kidneys of mice after ischemia-reperfusion, and we found that levels of factor B fragments (generated during alternative pathway activation) rapidly increase in the urine. We next performed a case-control study in which we measured complement fragments in human urine samples from patients undergoing cardiac surgery using ELISAs. The level of Ba increased after cardiac surgery and was significantly higher in patients who developed acute kidney injury. The increase in Ba also correlated with magnitude of the subsequent rise in serum creatinine and with the need for hemodialysis during the hospitalization. These findings demonstrate that the alternative pathway of complement is activated in patients who develop acute kidney injury after cardiac surgery and that increases in the level of urine Ba may be a predictive and functional biomarker of severe kidney injury.

Urine Biomarkers of Tubular Renal Cell Damage for the Prediction of Acute Kidney Injury After Cardiac Surgery—A Pilot Study

2017 ◽  
Vol 31 (6) ◽  
pp. 2072-2079 ◽  
Author(s):  
Tanja Mayer ◽  
Daniel Bolliger ◽  
Markus Scholz ◽  
Oliver Reuthebuch ◽  
Michael Gregor ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Cardiac Surgery ◽  
Pilot Study ◽  
Renal Cell ◽  
Cell Damage ◽  
Kidney Injury ◽  
Urine Biomarkers

Does long-term high-altitude exposure reduce myocardial injury and incidence of acute kidney injury following cardiac surgery? A propensity score matched study

2021 ◽  
Author(s):  
Mengxue Liu ◽  
Man Wang ◽  
Jia Huang ◽  
Zuojia Zeng ◽  
Keli Huang ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Cardiac Surgery ◽  
Propensity Score ◽  
High Altitude ◽  
Lower Incidence ◽  
Myocardial Injury ◽  
Ischemia Reperfusion ◽  
Kidney Injury ◽  
Altitude Exposure

Abstract Objective Chronic high-altitude exposure has been shown to reduce ischemia-reperfusion injury in animal experiments. The objective was to evaluate the clinical protective effect of long-term high-altitude hypoxic exposure for patients undergoing cardiac surgery with cardiopulmonary bypass. Methods In this retrospective cohort study, data from patients who underwent cardiac procedures between January 2013 and December 2019 at a single center was collected. Patients were divided into highlander group (> 2500 m) and lowlander group (< 1500 m) according to the altitude of their residence. A propensity-score-matched analysis was performed to estimate the association of long-term high-altitude exposure and cardiac surgery outcomes. Results In a total of 2085 patients, 128 highlander patients were matched to 248 lowlander patients. The levels of CK-MB and hs-TnI upon arrival at the intensive care unit were lower in the highlander group compared to the lowlander group [70.6 U/L (56.0, 92.6) vs 85.0 U/L (68.5, 113.5), P < 0.001; 6.1 ng/mL (3.3,11.2) vs 7.9 ng/mL (3.6, 14.1), P = 0.011, respectively]. The highlander group also had a lower incidence of acute kidney injury (13.3% vs 21.8%, P = 0.046). The in-hospital mortality in the highlander group was lower than in the lowlander group without statistical significance (0.8% vs 4.0%, P = 0.107). Conclusions Long-term high-altitude exposure was associated with less myocardial injury and a lower incidence of acute kidney injury after cardiac surgery.

scholarly journals S100A16 Promotes Acute Kidney Injury By Activating HRD1-Induced Ubiquitination And Degradation of GSK3β And CK1α

2021 ◽  
Author(s):  
Yifei Sun ◽  
Ya Fan ◽  
Min Li ◽  
Zheng Wang ◽  
Dongming Su ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Signaling Pathway ◽  
Calcium Binding ◽  
Ischemia Reperfusion Injury ◽  
Glycogen Synthase ◽  
Binding Protein ◽  
Ischemia Reperfusion ◽  
Kidney Injury ◽  
Calcium Binding Protein ◽  
Pathway Activation

Abstract The pathogenesis of acute kidney injury (AKI) is associated with activation of multiple signaling pathways, including Wnt/β-catenin signaling. However, the mechanism of Wnt/β-catenin pathway activation in renal interstitial fibroblasts during AKI is unclear. S100 calcium binding protein A16 (S100A16), a new member of calcium binding protein S100 family, is a multi-functional signaling factor involved in various pathogenies, including tumors, glycolipid metabolism disorder, and chronic kidney disease (CKD). We investigated the potential participation of S100A16 in Wnt/β-catenin pathway activation during AKI by subjecting wild-type (WT) and S100A16 knockout (S100A16+/-) mice to the ischemia-reperfusion injury (IRI), and revealed S100A16 upregulation in this model, in which knockout of S100A16 impeded the Wnt/β-catenin signaling pathway activation and recovered the expression of downstream hepatocyte growth factor (HGF). We also found that S100A16 was highly expressed in α-SMA positive renal fibroblasts in vivo. Consistently, in rat renal interstitial fibroblasts (NRK-49F cells), both hypoxia and S100A16 overexpression exacerbated fibroblasts apoptosis and inhibited HGF secretion; whereas S100A16 knockdown or Wnt/β-catenin pathway inhibitor ICG-001 reversed these changes. Mechanistically, we show that S100A16 promotes Wnt/β-catenin signaling activation via the ubiquitylation and degradation of β-catenin complex members, glycogen synthase kinase 3β (GSK3β) and casein kinase 1α (CK1α), mediated by E3 ubiquitin ligase, the HMG-CoA reductase degradation protein 1 (HRD1). Our study identified the S100A16 as a key regulator in the activation of Wnt/β-catenin signaling pathway in AKI.

scholarly journals Evaluation of 32 urine biomarkers to predict the progression of acute kidney injury after cardiac surgery

2014 ◽  
Vol 85 (2) ◽  
pp. 431-438 ◽  
Author(s):  
John M. Arthur ◽  
Elizabeth G. Hill ◽  
Joseph L. Alge ◽  
Evelyn C. Lewis ◽  
Benjamin A. Neely ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Cardiac Surgery ◽  
Kidney Injury ◽  
Urine Biomarkers

Preoperative Low Serum Albumin Levels Increase the Requirement of Renal Replacement Therapy after Cardiac Surgery

2016 ◽  
Vol 19 (3) ◽  
pp. 123 ◽  
Author(s):  
Orhan Findik ◽  
Ufuk Aydin ◽  
Ozgur Baris ◽  
Hakan Parlar ◽  
Gokcen Atilboz Alagoz ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Regression Analysis ◽  
Cardiac Surgery ◽  
Renal Replacement Therapy ◽  
Serum Albumin ◽  
Replacement Therapy ◽  
Kidney Injury ◽  
Preoperative Serum ◽  
Group I ◽  
Group Ii

<strong>Background:</strong> Acute kidney injury is a common complication of cardiac surgery that increases morbidity and mortality. The aim of the present study is to analyze the association of preoperative serum albumin levels with acute kidney injury and the requirement of renal replacement therapy after isolated coronary artery bypass graft surgery (CABG).<br /><strong>Methods:</strong> We retrospectively reviewed the prospectively collected data of 530 adult patients who underwent isolated CABG surgery with normal renal function. The perioperative clinical data of the patients included demographic data, laboratory data, length of stay, in-hospital complications and mortality. The patient population was divided into two groups: group I patients with preoperative serum albumin levels &lt;3.5 mg/dL; and group II pateints with preoperative serum albumin levels ≥3.5 mg/dL.<br /><strong>Results:</strong> There were 413 patients in group I and 117 patients in group II. Postoperative acute kidney injury (AKI) occured in 33 patients (28.2%) in group I and in 79 patients (19.1%) in group II. Renal replacement therapy was required in 17 patients (3.2%) (8 patients from group I; 9 patients from group II; P = .018). 30-day mortality occurred in 18 patients (3.4%) (10 patients from group I; 8 patients from group II; P = .037). Fourteen of these patients required renal replacement therapy. Logistic regression analysis revealing the presence of lower serum albumin levels preoperatively was shown to be associated with increased incidence of postoperative AKI (OR: 1.661; 95% CI: 1.037-2.661; <br />P = .035). Logistic regression analysis also revealed that DM (OR: 3.325; 95% CI: 2.162-5.114; P = .000) was another independent risk factor for AKI after isolated CABG. <br /><strong>Conclusion:</strong> Low preoperative serum albumin levels result in severe acute kidney injury and increase the rate of renal replacement therapy and mortality after isolated CABG.

Sign in / Sign up

Export Citation Format

Share Document