Abstract: FR-PO110
SLPI and Serpin E1 Differentiate between and Can Be Used as AKI Biomarkers in Patients with and without Obesity
Session Information
- AKI: Diagnosis and Outcomes
October 25, 2024 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Acute Kidney Injury
- 102 AKI: Clinical, Outcomes, and Trials
Authors
- Brown, Naomi A., Department of Cardiovascular Sciences and NIHR Cardiovascular Biomedical Research Unit, University of Leicester, Leicester, Leicestershire, United Kingdom
- Wozniak, Marcin, Department of Cardiovascular Sciences and NIHR Cardiovascular Biomedical Research Unit, University of Leicester, Leicester, Leicestershire, United Kingdom
- Pan, Haiyan, Affiliated Hospital of Nantong University Department of Cardiology, Nantong, Jiangsu, China
- Horley, Barbara, Department of Cardiovascular Sciences, College of Life Sciences, University of Leicester, Leicester, United Kingdom
- Joel David, Lathishia, Department of Cardiovascular Sciences and NIHR Cardiovascular Biomedical Research Unit, University of Leicester, Leicester, Leicestershire, United Kingdom
- Aujla, Hardeep, Department of Cardiovascular Sciences and NIHR Cardiovascular Biomedical Research Unit, University of Leicester, Leicester, Leicestershire, United Kingdom
- Murphy, Gavin J., Department of Cardiovascular Sciences and NIHR Cardiovascular Biomedical Research Unit, University of Leicester, Leicester, Leicestershire, United Kingdom
- Yang, Bin, Department of Cardiovascular Sciences, College of Life Sciences, University of Leicester, Leicester, United Kingdom
Background
Acute kidney injury (AKI) is among the most common complications after cardiac surgery, with an 18% prevalence and is associated with an increased risk of death. Cardiopulmonary bypass surgery generates danger-associated molecular patterns that trigger a release of proinflammatory molecules that can lead to AKI. Obesity is also associated with chronic low-grade inflammation and an increased risk for AKI. We investigated the utility of inflammatory molecules in the diagnosis of AKI in obese and non-obese cardiac surgery patients.
Methods
A panel of 13 circulating plasma molecules, including CXCL1, CXCL10, CXCL13, CCL22, IL-5,6,8,10,16, SLPI, TIM1, Properdin, Serpins E1 and A3, was measured using MAGPIX. The samples were collected from 95 MaRACAS patients (NCT02315183) before and 6-72 hours (h) after surgery. Obesity was defined as BMI>=32, based on our previous study.
Results
There was no significant difference in the incidence of AKI between obese (46%) and non-obese patients (58%). The levels of the selected molecules were compared between AKI and non-AKI groups in patients with and without obesity. In obese patients with AKI, the levels of serpin E1 were lower before surgery (22.16 vs 40.94ng/mL, q=0.03) and higher 6h post-surgery (49.26 vs 21.65ng/mL, q=0.02), while properdin was lower 72h post-surgery (11.12 vs 14.35ng/mL, q=0.01). In the non-obese group, CXCL10 was higher in the AKI group 6-48h post-surgery, peaking at 6h (218.5pg/mL vs 131.38pg/mL, q=0.02); CXCL13 was higher at 6h (435.78 vs 291.0pg/mL, q=0.04) and 24h (215.18 vs 157.49pg/mL, q=0.04); IL-16 was higher at 6h (256.01 vs 174.44, q=0.04) and 24h (344.94 vs 174.02, q=0.02); and SLPI was higher 6-72h post-surgery, peaking at 6h (50.44 vs 33.53 at 6h, q<0.01). ROC AUC analyses showed that Serpin E1 had a diagnostic value for AKI in obese patients pre (75.6%, 58.3%-92.8%) and 6h post-surgery (80%, 64.6%-95.4%); while SLPI had a diagnostic value in non-obese patients 6h after surgery (75.0%, 62.2%-87.8%).
Conclusion
AKI leads to different expression levels of proinflammatory molecules in obese and non-obese patients undergoing cardiac surgery. SLPI and Serpin E1 have diagnostic potential as biomarkers, but should be validated in larger cohorts.
Funding
- Private Foundation Support