Biomarkers of kidney injury indicate increased risk of death after discharge from cardiac surgery

December 20, 2013 by Helen Dodson, Yale University
Biomarkers of kidney injury indicate increased risk of death after discharge from cardiac surgery
Credit: Shutterstock

Following cardiac surgery, patients with elevated levels of kidney injury biomarkers are at a significantly higher risk of dying during the next three years, a Yale study has found. The results appear in the Journal of the American Society of Nephrology.

An earlier Yale study identified specific blood and urine markers that can predict which will suffer acute (AKI) after . AKI is a frequent complication of cardiac surgery, and the Yale investigators demonstrated that biomarkers predicted who is at risk of progressively worsening immediately after surgery.

The new study examined mortality at an average of three years after cardiac surgery. The researchers found that patients with clinically apparent AKI who also had high levels of urinary biomarkers of kidney injury, particularly interleukin (IL)-18 and kidney injury molecule (KIM)-1, faced a 2- to 3.2-fold increased risk for mortality over three years, compared with patients with the lowest levels of these biomarkers. However, the most interesting finding, say the researchers, was that even patients who have no evidence of clinical AKI, but who do have high levels of these injury biomarkers in their urine were also at higher risk of death.

The researchers believe these findings can provide an important way to assess patients—both with and without clinical AKI—in the immediate postoperative period in order to identify those who are at increased risk of death.

"AKI has traditionally been defined by serum creatinine, which represents changes in kidney function. This is the first study that links structural injury of the kidney with meaningful long-term outcomes," said senior author Chirag Parikh, M.D., director of the Program of Applied Translational Research and associate professor of nephrology at Yale School of Medicine and the Veterans Affairs Medical Center. "These newer biomarkers of kidney injury, often referred to as the 'troponins of the kidney,' have the potential to shape the future definitions and trials of ."

The Yale researchers, along with those from other institutions in the United States and Canada, are known as the Translational Research Investigating Biomarker End-Points in AKI consortium (TRIBE-AKI), a multidisciplinary group of academic investigators with expertise in pre-clinical, translational, epidemiological, and health services research.

Explore further: Acute kidney injury may be more deadly than heart attacks

Related Stories

Acute kidney injury may be more deadly than heart attacks

December 5, 2013
Acute kidney injury, a condition that is common but often asymptomatic, may be more deadly than a heart attack, according to a study appearing in an upcoming issue of the Clinical Journal of the American Society of Nephrology ...

Markers warn of progressive kidney problems after heart surgery

March 1, 2012
Blood and urine markers can indicate which patients with an abrupt kidney injury following heart surgery will experience progressive kidney problems, according to a study appearing in an upcoming issue of the Journal of the ...

Study expands use of biomarker for early diagnosis of acute kidney injury

September 5, 2013
A biomarker test developed initially to identify early acute kidney injury (AKI) after surgery has been shown to successfully detect AKI in emergency room patients with a variety of urgent health issues.

Hospitalized patients with acute kidney injury may not be receiving sufficient care after discharge

November 7, 2013
Acute kidney injury (AKI) is the most common in-hospital diagnosis seen by US nephrologists, but patients with the condition may not be receiving sufficient follow-up care. That's the conclusion of a study that will be presented ...

Warning signs predict kidney injury after surgery

August 12, 2011
Acute kidney injury (AKI) is a common – but preventable -- complication after surgery that can lead to other complications or even death. The use and development of biomarkers will help physicians diagnose and treat ...

Obese patients face increased risk of kidney damage after heart surgery

May 24, 2012
Oxidative stress may put obese patients at increased risk of developing kidney damage after heart surgery, according to a study appearing in an upcoming issue of the Journal of the American Society of Nephrology (JASN). Effective ...

Recommended for you

Creation of synthetic horsepox virus could lead to more effective smallpox vaccine

January 19, 2018
UAlberta researchers created a new synthetic virus that could lead to the development of a more effective vaccine against smallpox. The discovery demonstrates how techniques based on the use of synthetic DNA can be used to ...

Study ends debate over role of steroids in treating septic shock

January 19, 2018
The results from the largest ever study of septic shock could improve treatment for critically ill patients and save health systems worldwide hundreds of millions of dollars each year.

New approach could help curtail hospitalizations due to influenza infection

January 18, 2018
More than 700,000 Americans were hospitalized due to illnesses associated with the seasonal flu during the 2014-15 flu season, according to federal estimates. A radical new approach to vaccine development at UCLA may help ...

Zika virus damages placenta, which may explain malformed babies

January 18, 2018
Though the Zika virus is widely known for a recent outbreak that caused children to be born with microencephaly, or having a small head, and other malformations, scientists have struggled to explain how the virus affects ...

Certain flu virus mutations may compensate for fitness costs of other mutations

January 18, 2018
Seasonal flu viruses continually undergo mutations that help them evade the human immune system, but some of these mutations can reduce a virus's potency. According to new research published in PLOS Pathogens, certain mutations ...

Study reveals how MRSA infection compromises lymphatic function

January 17, 2018
Infections of the skin or other soft tissues with the hard-to-treat MRSA (methicillin-resistant Staphylococcus aureus) bacteria appear to permanently compromise the lymphatic system, which is crucial to immune system function. ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.