Elevated preoperative Galectin-3 is associated with acute kidney injury after cardiac surgery

Abstract

BackgroundPrevious research suggests that novel biomarkers may be used to identify patients at increased risk of acute kidney injury following cardiac surgery. The purpose of this study was to evaluate the relationship between preoperative levels of circulating Galectin-3 (Gal-3) and acute kidney injury after cardiac surgery.MethodsPreoperative serum Gal-3 was measured in 1498 patients who underwent coronary artery bypass graft (CABG) surgery and/or valve surgery as part of the Northern New England Biomarker Study between 2004 and 2007. Preoperative Gal-3 levels were measured using multiplex assays and grouped into terciles. Univariate and multinomial logistic regression was used to assess the predictive ability of Gal-3 terciles and AKI occurrence and severity.ResultsBefore adjustment, patients in the highest tercile of Gal-3 had a 2.86-greater odds of developing postoperative KDIGO Stage 2 or 3 (p < 0.001) and 1.70-greater odds of developing KDIGO Stage 1 (p = < 0.001), compared to the first tercile. After adjustment, patients in the highest tercile had 2.95-greater odds of developing KDIGO Stage 2 or 3 (p < 0.001) and 1.71-increased odds of developing KDIGO Stage 1 (p = 0.001), compared to the first tercile. Compared to the base model, the addition of Gal-3 terciles improved discriminatory power compared to without Gal-3 terciles (test of equality = 0.042).ConclusionElevated preoperative Gal-3 levels significantly improves predictive ability over existing clinical models for postoperative AKI and may be used to augment risk information for patients at the highest risk of developing AKI and AKI severity after cardiac surgery.

Galectin-3 In Septic Acute Kidney Injury: A Translational Study

“…This is the rst report of such a nding in patients with sepsis. It is consistent with previous ndings that preoperative serum Gal-3 predicts AKI after cardiac surgery [27], and that Gal-3 at the time of ICU discharge is associated with severity of AKI [28]. Our ndings are also consistent with various murine experiments, which demonstrated causal roles for Gal-3 in AKI produced by various insults [28,[33][34][35][36].…”

“…We found that elevated Gal-In patients admitted to the ICU with sepsis, elevated serum Gal-3 levels at admission predicted ICU mortality. Our ndings are consistent with other clinical research in which serum Gal-3 levels predicted 30day all-cause mortality in sepsis [26], as well as murine experiments demonstrating the important role of Gal-3 in sepsis pathogenesis and mortality [27,30]. Our ndings suggest that serum Gal-3 may serve as a prognostic indicator in sepsis.…”

“…Epidemiologic studies have found an association between serum Gal-3 level and risk of sepsis [20][21][22] as well as development of chronic kidney disease (CKD) [23][24][25]. Pertinent ndings show that serum Gal-3 predicts 30-day all-cause mortality in sepsis [26], preoperative serum Gal-3 predicts AKI after cardiac surgery [27], and serum Gal-3 at ICU discharge is associated with severity of AKI [28]. However, no previous study has examined the relationship between serum Gal-3 at the time of admission and the subsequent development of AKI in patients with sepsis.…”

Biomarkers of Acute Kidney Injury after Cardiac Surgery: A Narrative Review

“…Patients with AKI tend to have a higher level of MCP-1 and a higher risk of death within 3 years of follow-up than non-AKI patients [102]. Moritz et al [103] proposed adding circulating Galectin-3 to a clinical model to improve discriminatory power. A prospective study enrolling infants and young children after CPB reported that the joint use of CPB time and the plasma gelsolin (GSN) level at 6 h postoperation presented an excellent predictive value for AKI [104].…”

Galectin-3 in septic acute kidney injury: a translational study

“…Epidemiologic studies have found an association between serum Gal-3 level and risk of sepsis [ 20 – 22 ] as well as development of chronic kidney disease (CKD) [ 23 – 25 ]. Pertinent findings show that serum Gal-3 predicts 30-day all-cause mortality in sepsis [ 26 ], preoperative serum Gal-3 predicts AKI after cardiac surgery [ 27 ], and serum Gal-3 at ICU discharge is associated with severity of AKI [ 28 ]. However, no previous study has examined the relationship between serum Gal-3 at the time of admission and the subsequent development of AKI in patients with sepsis.…”