Urinary Spermidine Predicts and Associates with In-Hospital Acute Kidney Injury after Cardiac Surgery

• Published in: Antioxidants Vol. 10; no. 6; p. 896
• Main Authors: Martin-Lorenzo, Marta, Ramos-Barron, Angeles, Gutierrez-Garcia, Paula, Martin-Blazquez, Ariadna, Santiago-Hernandez, Aranzazu, Rodrigo Calabia, Emilio, Gomez-Alamillo, Carlos, Alvarez-Llamas, Gloria
• Format: Journal Article
• Language: English
• Published: Basel MDPI AG 02.06.2021; MDPI
• Subjects: Acids; acute kidney injury; cardiovascular; Creatinine; Heart; Heart surgery; Kidney diseases; Kidneys; KIM-1; Mass spectrometry; Mass spectroscopy; Metabolism; Metabolites; NGAL; NMR; Nuclear magnetic resonance; p-Hydroxyphenylacetic acid; Patients; Peritoneal dialysis; Scientific imaging; Software; Spermidine; Statistical analysis; Surgery; Urine; United States > US; Germany
• ISSN: 2076-3921; 2076-3921
• DOI: 10.3390/antiox10060896

Acute Kidney Injury (AKI) affects up to 30% of the patients who undergo cardiac surgery (CVS) and is related to higher mortality. We aim to investigate molecular features associated with in-hospital AKI development and determine the predictive value of these features when analyzed preoperatively. This is a case-control study. From an initial cohort of 110 recruited subjects, a total of 60 patients undergoing cardiac surgery were included: 20 (33%) developed in-hospital AKI (CVS-AKI) and 40 did not (controls, CVS-C). Pre- and post-surgery samples were collected and a prospective study was carried out. A total of 312 serum samples and 258 urine samples were analyzed by nuclear magnetic resonance, mass spectrometry and ELISA. Six features predicted AKI development in pre-surgery samples: urinary kidney functional loss marker kidney injury molecule-1 (uKIM-1), 2-hydroxybutyric acid, 2-hydroxyphenylacetic acid, hippuric acid, phosphoethanolamine and spermidine. Two of them stood out as powerful predictors. Pre-surgery uKIM-1 levels were increased in CVS-AKI vs. CVS-C (AUC = 0.721, p-value = 0.0392) and associated strongly with the outcome (OR = 5.333, p-value = 0.0264). Spermidine showed higher concentration in CVS-AKI (p-value < 0.0001, AUC = 0.970) and had a strong association with the outcome (OR = 69.75, p-value < 0.0001). uKIM-1 and particularly spermidine predict in-hospital AKI associated with CVS in preoperative samples. These findings may aid in preventing postoperative AKI and improve prognosis of CVS.