Plasma renalase as a biomarker of acute kidney injury after cardiac surgery

Ibrahim, Ihab; Sayed, Haitham; Mohammed, Amal

doi:10.4103/1110-7782.200966

Cited by 5 publications

(6 citation statements)

References 39 publications

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“…Third, our results highlight the role of renalase in acute disease states where decreased in renalase level was associated with poor outcome. Similar dynamic relationship has been observed in other acute cardiac and renal diseases [ 20 , 21 , 27 ]. It should be noted that renalase may behave differently in type 1 diabetes [ 43 ] or in chronic inflammatory states such as systemic lupus erythematosus, where increased serum renalase has been observed in response to chronic inflammation and is attenuated with immunosuppressive therapy [ 44 ].…”

Section: Discussionsupporting

confidence: 84%

Association of renalase with clinical outcomes in hospitalized patients with COVID-19

et al. 2022

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Renalase is a secreted flavoprotein with anti-inflammatory and pro-cell survival properties. COVID-19 is associated with disordered inflammation and apoptosis. We hypothesized that blood renalase levels would correspond to severe COVID-19 and survival. In this retrospective cohort study, clinicopathologic data and blood samples were collected from hospitalized COVID-19 subjects (March—June 2020) at a single institution tertiary hospital. Plasma renalase and cytokine levels were measured and clinical data abstracted from health records. Of 3,450 COVID-19 patients, 458 patients were enrolled. Patients were excluded if <18 years, or opted out of research. The primary composite outcome was intubation or death within 180 days. Secondary outcomes included mortality alone, intensive care unit admission, use of vasopressors, and CPR. Enrolled patients had mean age 64 years (SD±17), were 53% males, and 48% non-whites. Mean renalase levels was 14,108·4 ng/ml (SD±8,137 ng/ml). Compared to patients with high renalase, those with low renalase (< 8,922 ng/ml) were more likely to present with hypoxia, increased ICU admission (54% vs. 33%, p < 0.001), and cardiopulmonary resuscitation (10% vs. 4%, p = 0·023). In Cox proportional hazard model, every 1000 ng/ml increase in renalase decreased the risk of death or intubation by 5% (HR 0·95; 95% CI 0·91–0·98) and increased survival alone by 6% (HR 0·95; CI 0·90–0·98), after adjusting for socio-demographics, initial disease severity, comorbidities and inflammation. Patients with high renalase-low IL-6 levels had the best survival compared to other groups (p = 0·04). Renalase was independently associated with reduced intubation and mortality in hospitalized COVID-19 patients. Future studies should assess the pathophysiological relevance of renalase in COVID-19 disease.

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Section: Discussionsupporting

confidence: 84%

Association of renalase with clinical outcomes in hospitalized patients with COVID-19

et al. 2022

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“…It is common postcardiac surgery in children due to renal hypoperfusion, reperfusion injury, and inflammatory responses. [ 2 ] Degree of hemodilution and hormonal response to CPB in pediatric population makes it vulnerable for AKI. Thus, early AKI diagnosis is of great significance for prognosis of patients.…”

Section: Discussionmentioning

confidence: 99%

“…found AUC 0.375 for plasma renalase while serum NGAL had AUC 0.663 at 24hrs after surgery for prediction of AKI. [ 2 ] Wang et al . investigated diagnostic role of urinary IL-18 after CPB with AUC = 0.90 as early as 2 h after CPB and with AUC of urinary NGAL being 0.83.…”

Section: Discussionmentioning

confidence: 99%

“…[ 1 ] It is an independent predictor of morbidity and mortality in children who undergo cardiac surgery with mortality rate of 8% compared with 0.9% in patients without AKI. [ 2 ] Pathophysiology includes decreased renal perfusion, lack of pulsatile flow, oxidative stress, hypothermia, embolism, and inflammatory response. [ 2 ] Variables such as increased duration of surgery, aortic cross-clamp, and intraoperative hypotension cause AKI.…”

Section: Introductionmentioning

confidence: 99%

“…[ 2 ] Pathophysiology includes decreased renal perfusion, lack of pulsatile flow, oxidative stress, hypothermia, embolism, and inflammatory response. [ 2 ] Variables such as increased duration of surgery, aortic cross-clamp, and intraoperative hypotension cause AKI. There are various scoring systems based on serum creatinine and urine output to define AKI in children such as Pediatric Risk Injury Failure Loss End Stage (PRIFLE), Acute Kidney Injury Network (AKIN), and Kidney Disease Improving Global Outcomes (KDIGO).…”

Section: Introductionmentioning

confidence: 99%

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Early prediction of acute kidney injury using serum phosphorus as a biomarker in pediatric cardiac surgical patients

Burra¹,

Nagaraja²,

Singh³

et al. 2018

Ann Card Anaesth

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Background:Acute kidney injury (AKI) is a strong predictor of morbidity and mortality after cardiac surgery. Lack of valid early biomarkers for predicting AKI has hampered the ability to take therapeutic measures for preventive cause. Hyperphosphatemia that occurs in AKI due to renal excretion defect was not studied in this context and could be simple marker of AKI. Therefore, we tested role of serum phosphorus in prediction of AKI as a biomarker after cardiac surgery in children.Methodology:We prospectively evaluated 51 children aged between 3 weeks and 12 years undergoing elective cardiac surgery. Serum creatinine and phosphorus were measured preoperatively and postoperatively at 24 and 48 h. As per the Kidney Disease Improving Global Outcomes criteria, patients were grouped into AKI and non-AKI on the basis of the development of AKI within 48 h postsurgery. The postoperative diagnostic performance of phosphorus thresholds was analyzed by the area under receiver operating characteristic curves (AUC-ROC).Results:From 51 children included, 10 developed AKI. In AKI group, serum phosphorus increased significantly from 4.47 ± 0.43 baseline to 6.29 ± 0.32 at 24 h postsurgery (P = 0.01) while serum creatinine increased from baseline 0.33 (0.24–0.46) to 0.49 (0.26–0.91) at 24 h which is statistically insignificant (P = 0.16). ROC analysis showed that serum phosphorus at 24 h, the AUC was 0.84 with sensitivity 0.75 and specificity 0.93 for a cutoff value of 6.4 mg/dl. Whereas serum phosphorus at 48 h, the AUC was 0.86 with sensitivity 66.67% and specificity 97.62% for a cutoff value of 5.4 mg/dl.Conclusion:Serum phosphorus can be an alternative biomarker as early as 24 h for early prediction of AKI in pediatric cardiac surgery.

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