scholarly journals Chronic Kidney Disease-Associated Inflammation Increases the Risks of Acute Kidney Injury and Mortality after Cardiac Surgery

2020 ◽  
Vol 21 (24) ◽  
pp. 9689
Author(s):  
Angela Casas ◽  
Adrián Mallén ◽  
Arnau Blasco-Lucas ◽  
Fabrizio Sbraga ◽  
Jordi Guiteras ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Adipose Tissue ◽  
Cardiac Surgery ◽  
Coronary Artery ◽  
Map Kinases ◽  
Kidney Diseases ◽  
Bypass Graft ◽  
Kidney Injury ◽  
Perivascular Adipose Tissue ◽  
Increased Risk

Cardiovascular mortality increases with decreasing renal function although the cause is yet unknown. Here, we have investigated whether low chronic inflammation in chronic kidney diseases (CKD) could contribute to increased risk for coronary artery diseases (CAD). Thus, a prospective case–control study was conducted in patients with CAD and CKD undergoing coronary artery bypass graft surgery with the aim of detecting differences in cardiovascular outcomes, epicardial adipose tissue volume, and inflammatory marker activity associated with renal dysfunction. Expression of membrane CD14 and CD16, inflammatory cytokines and chemokines, mitogen-activated protein (MAP) kinases and hsa-miR-30a-5p were analyzed in peripheral blood mononuclear cells (PBMCs). Epicardial fat volume and tissue inflammation in perivascular adipose tissue and in the aorta were also studied. In the present study, 151 patients were included, 110 with CAD (51 with CKD) and 41 nonCAD controls (15 with CKD). CKD increased the risk of cardiac surgery–associated acute kidney injury (CSA-AKI) as well as the 30-day mortality after cardiac surgery. Higher counts of CD14++CD16+ monocytes were associated with vascular inflammation, with an increased expression of IL1β, and with CKD in CAD patients. Expression of hsa-miR-30a-5p was correlated with hypertension. We conclude that CKD patients show an increased risk of CSA-AKI and mortality after cardiovascular surgery, associated with the expansion of the CD14++CD16+ subset of proinflammatory monocytes and with IL1β expression. We propose that inflammation associated with CKD may contribute to atherosclerosis (ATH) pathogenesis.

scholarly journals Postoperative acute kidney injury in adult non-cardiac surgery: joint consensus report of the Acute Disease Quality Initiative and PeriOperative Quality Initiative

2021 ◽  
Author(s):  
John R. Prowle ◽  
Lui G. Forni ◽  
Max Bell ◽  
Michelle S. Chew ◽  
Mark Edwards ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Acute Kidney Injury ◽  
Cardiac Surgery ◽  
Kidney Disease ◽  
Kidney Injury ◽  
Adverse Outcomes ◽  
Baseline Risk ◽  
Major Surgery ◽  
Increased Risk

AbstractPostoperative acute kidney injury (PO-AKI) is a common complication of major surgery that is strongly associated with short-term surgical complications and long-term adverse outcomes, including increased risk of chronic kidney disease, cardiovascular events and death. Risk factors for PO-AKI include older age and comorbid diseases such as chronic kidney disease and diabetes mellitus. PO-AKI is best defined as AKI occurring within 7 days of an operative intervention using the Kidney Disease Improving Global Outcomes (KDIGO) definition of AKI; however, additional prognostic information may be gained from detailed clinical assessment and other diagnostic investigations in the form of a focused kidney health assessment (KHA). Prevention of PO-AKI is largely based on identification of high baseline risk, monitoring and reduction of nephrotoxic insults, whereas treatment involves the application of a bundle of interventions to avoid secondary kidney injury and mitigate the severity of AKI. As PO-AKI is strongly associated with long-term adverse outcomes, some form of follow-up KHA is essential; however, the form and location of this will be dictated by the nature and severity of the AKI. In this Consensus Statement, we provide graded recommendations for AKI after non-cardiac surgery and highlight priorities for future research.

scholarly journals The Incidence and Risk Factors of Acute Kidney Injury After Coronary Artery Bypass Graft Surgery

2015 ◽  
Vol 1 (3) ◽  
Author(s):  
Samira Tabiban ◽  
Turaj Babaee ◽  
Behshid Ghadrdoost ◽  
Hooman Bakhshandeh ◽  
Ali Sadeghpour Tabaei ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Kidney Injury ◽  
Coronary Artery ◽  
Coronary Artery Bypass Graft ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Kidney Injury ◽  
Artery Bypass Graft

scholarly journals Perivascular Adipose Tissue Inflammation in Ischemic Heart Disease

2021 ◽  
Vol 41 (3) ◽  
pp. 1239-1250
Author(s):  
Celestina Mazzotta ◽  
Sanchita Basu ◽  
Adam C. Gower ◽  
Shakun Karki ◽  
Melissa G. Farb ◽  
...  
Keyword(s):  
Adipose Tissue ◽  
Coronary Artery ◽  
Quantitative Polymerase Chain Reaction ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Artery Bypass Graft ◽  
Chain Reaction ◽  
Perivascular Adipose Tissue ◽  
Polymerase Chain ◽  
Artery Disease

Objective: There is growing recognition that adipose tissue–derived proatherogenic mediators contribute to obesity-related cardiovascular disease. We sought to characterize regional differences in perivascular adipose tissue (PVAT) phenotype in relation to atherosclerosis susceptibility. Approach and Results: We examined thoracic PVAT samples in 34 subjects (body mass index 32±6 kg/m 2 , age 59±11 years) undergoing valvular, aortic, or coronary artery bypass graft surgeries and performed transcriptomic characterization using whole-genome expression profiling and quantitative polymerase chain reaction analyses. We identified a highly inflamed region of PVAT surrounding the human aortic root in close proximity to coronary takeoff and adjoining epicardial fat. In subjects undergoing coronary artery bypass graft, we found 300 genes significantly upregulated (false discovery rate Q <0.1) in paired samples of PVAT surrounding the aortic root compared with nonatherosclerotic left internal mammary artery. Genes encoding proteins mechanistically implicated in atherogenesis were enriched in aortic PVAT consisting of signaling pathways linked to inflammation, WNT (wingless-related integration site) signaling, matrix remodeling, coagulation, and angiogenesis. Overexpression of several proatherogenic transcripts, including IL1β , CCL2 ( MCP-1 ), and IL6 , were confirmed by quantitative polymerase chain reaction and significantly bolstered in coronary artery disease subjects. Angiographic coronary artery disease burden quantified by the Gensini score positively correlated with the expression of inflammatory genes in PVAT. Moreover, periaortic adipose inflammation was markedly higher in obese subjects with striking upregulation (≈8-fold) of IL1β expression compared to nonobese individuals. Conclusions: Proatherogenic mediators that originate from dysfunctional PVAT may contribute to vascular disease mechanisms in human vessels. Moreover, PVAT may adopt detrimental properties under obese conditions that play a key role in the pathophysiology of ischemic heart disease. Graphic Abstract: A graphic abstract is available for this article.

Nuclear DNA as Predictor of Acute Kidney Injury in Patients Undergoing Coronary Artery Bypass Graft: A Pilot Study

2017 ◽  
Vol 31 (6) ◽  
pp. 2080-2085 ◽  
Author(s):  
Valery V. Likhvantsev ◽  
Giovanni Landoni ◽  
Oleg A. Grebenchikov ◽  
Yuri V. Skripkin ◽  
Tatiana S. Zabelina ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Coronary Artery ◽  
Pilot Study ◽  
Coronary Artery Bypass Graft ◽  
Coronary Artery Bypass ◽  
Nuclear Dna ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Kidney Injury ◽  
Artery Bypass Graft

scholarly journals Acute kidney injury after a coronary artery bypass graft surgery

2021 ◽  
Vol 5 (3) ◽  
pp. 204
Author(s):  
KunArifi Abbas ◽  
NancyMargarita Rehatta ◽  
YanEfrata Sembiring ◽  
Ghuraba Adisurya ◽  
PranandaSurya Airlangga ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Coronary Artery ◽  
Coronary Artery Bypass Graft ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Kidney Injury ◽  
Artery Bypass Graft

CIRP Secretion during Cardiopulmonary Bypass Is Associated with Increased Risk of Postoperative Acute Kidney Injury

2021 ◽  
Author(s):  
Wenyan Liu ◽  
Yang Yan ◽  
Dan Han ◽  
Yongxin Li ◽  
Qian Wang ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Cardiac Surgery ◽  
Cardiopulmonary Bypass ◽  
Rna Binding ◽  
Multivariable Analysis ◽  
Kidney Injury ◽  
Proinflammatory Response ◽  
Increased Risk ◽  
Before And After ◽  
The Difference

Abstract Background Systemic inflammation contributes to cardiac surgery–associated acute kidney injury (AKI). Cardiomyocytes and other organs experience hypothermia and hypoxia during cardiopulmonary bypass (CPB), which induces the secretion of cold-inducible RNA-binding protein (CIRP). Extracellular CIRP may induce a proinflammatory response. Materials and Methods The serum CIRP levels in 76 patients before and after cardiac surgery were determined to analyze the correlation between CIRP levels and CPB time. The risk factors for AKI after cardiac surgery and the in-hospital outcomes were also analyzed. Results The difference in the levels of CIRP (ΔCIRP) after and before surgery in patients who experienced cardioplegic arrest (CA) was 26-fold higher than those who did not, and 2.7-fold of those who experienced CPB without CA. The ΔCIRP levels were positively correlated with CPB time (r = 0.574, p < 0.001) and cross-clamp time (r = 0.54, p < 0.001). Multivariable analysis indicated that ΔCIRP (odds ratio: 1.003; 95% confidence interval: 1.000–1.006; p = 0.027) was an independent risk factor for postoperative AKI. Patients who underwent aortic dissection surgery had higher levels of CIRP and higher incidence of AKI than other patients. The incidence of AKI and duration of mechanical ventilation in patients whose serum CIRP levels more than 405 pg/mL were significantly higher than those less than 405 pg/mL (65.8 vs. 42.1%, p = 0.038; 23.1 ± 18.2 vs. 13.8 ± 9.2 hours, p = 0.007). Conclusion A large amount of CIRP was released during cardiac surgery. The secreted CIRP was associated with the increased risk of AKI after cardiac surgery.

scholarly journals Reproducible Large-Scale Isolation of Exosomes from Adipose Tissue-Derived Mesenchymal Stem/Stromal Cells and Their Application in Acute Kidney Injury

2020 ◽  
Vol 21 (13) ◽  
pp. 4774 ◽  
Author(s):  
Jun Ho Lee ◽  
Dae Hyun Ha ◽  
Hyeon-kyu Go ◽  
Jinkwon Youn ◽  
Hyun-keun Kim ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Adipose Tissue ◽  
Stromal Cells ◽  
Large Scale ◽  
Kidney Diseases ◽  
Kidney Injury ◽  
Preclinical Studies ◽  
Scale Production ◽  
Positive Effects ◽  
Large Scale Production

Acute kidney injury (AKI) is a fatal medical episode caused by sudden kidney damage or failure, leading to the death of patients within a few hours or days. Previous studies demonstrated that exosomes derived from various mesenchymal stem/stromal cells (MSC-exosomes) have positive effects on renal injuries in multiple experimental animal models of kidney diseases including AKI. However, the mass production of exosomes is a challenge not only in preclinical studies with large animals but also for successful clinical applications. In this respect, tangential flow filtration (TFF) is suitable for good manufacturing practice (GMP)-compliant large-scale production of high-quality exosomes. Until now, no studies have been reported on the use of TFF, but rather ultracentrifugation has been almost exclusively used, to isolate exosomes for AKI therapeutic application in preclinical studies. Here, we demonstrated the reproducible large-scale production of exosomes derived from adipose tissue-derived MSC (ASC-exosomes) using TFF and the lifesaving effect of the ASC-exosomes in a lethal model of cisplatin-induced rat AKI. Our results suggest the possibility of large-scale stable production of ASC-exosomes without loss of function and their successful application in life-threatening diseases.

scholarly journals Effect of Ascorbic Acid on Postoperative Acute Kidney Injury in Coronary Artery Bypass Graft Patients: A Pilot Study

2017 ◽  
Vol 20 (5) ◽  
pp. 214 ◽  
Author(s):  
Miha Antonic
Keyword(s):  
Acute Kidney Injury ◽  
Ascorbic Acid ◽  
Cardiac Surgery ◽  
Coronary Artery ◽  
Serum Creatinine ◽  
Renal Injury ◽  
Artery Bypass ◽  
Kidney Injury ◽  
Acid Group ◽  
Postoperative Serum

Background: Even minor postoperative reductions in renal function influence the outcome of cardiac surgery. The mechanisms of postoperative renal injury in cardiac surgery are multifactorial and include ischemia-reperfusion injury. The study investigates the effect of the antioxidant ascorbic acid on the postoperative acute kidney injury after elective CABG surgery.Methods: A prospective randomized single-center trial was conducted in on-pump coronary artery bypass patients. The patients in the ascorbic acid group received 2 grams of ascorbic acid 24 hours and 2 hours preoperatively and 1 gram twice daily five days after the surgery.  Postoperatively, the subjects were monitored for renal dysfunction and other complications.Results: 100 patients were included, with 50 patients in each study group. The groups were well matched for baseline demographics, preoperative medications, comorbidities, and had similar intraoperative characteristics. The incidence of postoperative acute kidney injury in the ascorbic acid group was 16% and 14% in the control group (P = .779). The groups also did not differ in peak postoperative serum creatinine (83 [33] µmol/L versus 83 [39] µmol/L; P = .434), the lowest postoperative creatinine clearance (96.40 ± 35.78 mL/min versus 90.89 ± 36.18 mL/min; P = .766), and time from surgery to the onset of peak postoperative serum creatinine (1.64 ± 1.34 days versus 1.92 ± 1.54 days; P = .393). There was no dialysis required in any patient. Conclusion: The results of this study did not demonstrate a significant protective effect of ascorbic acid on the incidence of postoperative acute renal injury in elective on-pump CABG patients.

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