Prognostic value of suPAR and hsCRP on acute kidney injury after cardiac surgery

Sebastian Roed Rasmussen*, Rikke Vibeke Nielsen, Rasmus Møgelvang, Sisse Rye Ostrowski, Hanne Berg Ravn

*Kontaktforfatter

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Abstract

Background: Acute kidney injury (AKI) represents a serious complication following cardiac surgery. Adverse outcome after cardiac surgery has been observed in the presence of elevated levels of soluble urokinase-type plasminogen activator receptor (suPAR) and high-sensitivity C-Reactive Protein (hsCRP). The aim of study was (i) to investigate the relationship between preoperative elevated levels of suPAR and hsCRP and postoperative AKI in unselected cardiac surgery patients and (ii) to assess whether the concentration of the biomarkers reflected severity of AKI. Methods: In a retrospective observational study, biobank blood plasma samples (n = 924) from patients admitted for elective on-pump cardiac surgery were analysed for suPAR and hsCRP levels. The relation between suPAR and hsCRP-values and AKI (any stage), defined by the KDIGO (Kidney Disease: Improving Global Outcomes) criteria, was assessed using adjusted logistic regression. Further, the association between biomarkers and severity (KDIGO 1, KDIGO 2–3 and renal replacement therapy (RRT)) was assessed using adjusted logistic regression. Results: Postoperative AKI (any stage) was observed in 327 patients (35.4 %). A doubling of preoperative suPAR corresponded to an adjusted odds ratio (OR) for postoperative AKI (any stage) of 1.62 (95 % CI 1.26–2.09, p < 0.001). Furthermore, a doubling of suPAR had an adjusted OR of 1.50 (95 % CI 1.16–1.93, p = 0.002), 2.44 (95 % CI 1.56–3.82, p < 0.001) and 1.92 (95 % CI 1.15–3.23, p = 0.002), for KDIGO 1, KDIGO 2–3 and need for RRT, respectively. No significant association was found between elevated levels of hsCRP and any degree of AKI. Conclusions: Increasing levels of suPAR, but not hsCRP, were associated with development and severity of AKI following on-pump cardiac surgery.

OriginalsprogEngelsk
Artikelnummer120
TidsskriftBMC Nephrology
Vol/bind22
Antal sider10
ISSN1471-2369
DOI
StatusUdgivet - 7. apr. 2021

Bibliografisk note

Funding Information:
Work was supported by The Heart Center’s Research Foundation at Rigshospitalet to cover costs of the biochemical analyses of suPAR and hsCRP. Establishment of PERSIMUNE was supported by the Danish National Research Foundation [grant 126]. SRR was supported by The Heart Center’s Research Committee at Rigshospitalet and Arvid Nilsson’s Foundation. Neither of the mentioned foundations had any economic interest or investment in the applied methods or outcome.

Funding Information:
Preliminary data for this study was presented as a poster presentation at the 35th Annual European Association of Cardiothoracic Anaesthesiology (EACTA) Congress, 4-6 November 2020 (virtual meeting).

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