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Urinary Spermidine Predicts and Associates with In-Hospital Acute Kidney Injury after Cardiac Surgery

Acute Kidney Injury (AKI) affects up to 30% of the patients who undergo cardiac surgery (CVS) and is related to higher mortality. We aim to investigate molecular features associated with in-hospital AKI development and determine the predictive value of these features when analyzed preoperatively. Th...

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Main Authors: Marta Martin-Lorenzo (Author), Angeles Ramos-Barron (Author), Paula Gutierrez-Garcia (Author), Ariadna Martin-Blazquez (Author), Aranzazu Santiago-Hernandez (Author), Emilio Rodrigo Calabia (Author), Carlos Gomez-Alamillo (Author), Gloria Alvarez-Llamas (Author)
Format: Book
Published: MDPI AG, 2021-06-01T00:00:00Z.
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Summary:Acute Kidney Injury (AKI) affects up to 30% of the patients who undergo cardiac surgery (CVS) and is related to higher mortality. We aim to investigate molecular features associated with in-hospital AKI development and determine the predictive value of these features when analyzed preoperatively. This is a case-control study. From an initial cohort of 110 recruited subjects, a total of 60 patients undergoing cardiac surgery were included: 20 (33%) developed in-hospital AKI (CVS-AKI) and 40 did not (controls, CVS-C). Pre- and post-surgery samples were collected and a prospective study was carried out. A total of 312 serum samples and 258 urine samples were analyzed by nuclear magnetic resonance, mass spectrometry and ELISA. Six features predicted AKI development in pre-surgery samples: urinary kidney functional loss marker kidney injury molecule-1 (uKIM-1), 2-hydroxybutyric acid, 2-hydroxyphenylacetic acid, hippuric acid, phosphoethanolamine and spermidine. Two of them stood out as powerful predictors. Pre-surgery uKIM-1 levels were increased in CVS-AKI vs. CVS-C (AUC = 0.721, <i>p</i>-value = 0.0392) and associated strongly with the outcome (OR = 5.333, <i>p</i>-value = 0.0264). Spermidine showed higher concentration in CVS-AKI (<i>p</i>-value < 0.0001, AUC = 0.970) and had a strong association with the outcome (OR = 69.75, <i>p</i>-value < 0.0001). uKIM-1 and particularly spermidine predict in-hospital AKI associated with CVS in preoperative samples. These findings may aid in preventing postoperative AKI and improve prognosis of CVS.
Item Description:10.3390/antiox10060896
2076-3921

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