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- Title
Association of genetic polymorphisms with acute kidney injury after cardiac surgery in a Southeast Asian population.
- Authors
Saw, Kah Ming Eddy; Ng, Rui Ge Roderica; Chan, Siew Pang; Ang, Yi Hui; Ti, Lian Kah; Chew, Tsong Huey Sophia
- Abstract
Introduction: Genetic polymorphisms are important in explaining the wide interpatient variability that exists in the development of acute kidney injury (AKI) post cardiac surgery. We hypothesised that polymorphisms in 4 candidate genes, namely angiotensin-converting enzyme (ACE), apolipoprotein-E (ApoE), interleukin-6 (IL-6), and tumour necrosis factor-alpha (TNF-α) are associated with AKI. Methods: 870 patients who underwent cardiac surgery in Singapore were analysed. All patients who fulfilled stage 1 KDIGO criteria and above were considered to have AKI. This was investigated against various demographic, clinical and genetic factors. Results: Increased age, history of hypertension, anaemia and renal impairment remained important preoperative risk factors for AKI. Intraoperatively, longer cardiopulmonary bypass (CPB) time and the use of intra-aortic balloon pump (IABP) were shown to be associated with AKI. Among the genetic factors, ACE-D allele was associated with an increased risk of AKI while IL6-572C allele was associated with a decreased risk of AKI. Conclusion: ACE-D allele was associated with the development of AKI similar to other studies. On the other hand, IL6-572C was shown to have a protective role against the development of AKI, contradictory to studies done in the Caucasian population. This contradictory effect of IL6-572C is a result of a complex interplay between the gene and population specific modulating factors. Our findings further underscored the necessity of taking into account population specific differences when developing prediction models for AKI.
- Subjects
SINGAPORE; CARDIAC surgery; GENETIC polymorphisms; TUMOR necrosis factors; INTRA-aortic balloon counterpulsation; KIDNEY injuries; CARDIOPULMONARY bypass
- Publication
PLoS ONE, 2019, Vol 14, Issue 4, p1
- ISSN
1932-6203
- Publication type
Article
- DOI
10.1371/journal.pone.0213997