Apolipoprotein E genotype, TNF-α 308G/A and risk for cardiac surgery associated-acute kidney injury in Caucasians. (March 2014)

• Record Type: Journal Article
• Authors: Boehm, Johannes; Eichhorn, Stefan; Kornek, Matthias; Hauner, Katharina; Prinzing, Anatol; Grammer, Joachim; Lahm, Harald; Wagenpfeil, Stefan; Lange, Ruediger
• Is Part Of: Renal failure. Volume 36:Number 2(2014)
• Page Start: 237
• Page End: 243
• Publication Date: 2014-03
• Subjects: Chronic renal failure -- Periodicals; Acute renal failure -- Periodicals; Uremia -- Periodicals; 616.614005
• DOI: 10.3109/0886022X.2013.835267
• Languages: English
• ISSNs: 0886-022X

Abstract

<abstract> <title>Abstract</title> <p> <italic>Objectives</italic>: Acute kidney injury following cardiac surgery depicts a severe clinical problem that is strongly associated with adverse short- and long-term outcome. We analyzed two common genetic polymorphisms that have previously been linked to renal failure and inflammation, and have been supposed to be associated with cardiac surgery associated-acute kidney injury (CSA-AKI). <italic>Methods</italic>: A total of 1415 consecutive patients who underwent elective cardiac surgery with CPB at our institution were prospectively enrolled. Patients were genotyped for Apolipoprotein E (ApoE E2, E3, E4) (rs429358 and rs7412) and TNF-α-308 G > A (rs1800629). <italic>Results</italic>: Demographic characteristics and procedural data revealed no significant differences between genotypes. No association between ApoE (E2, E3, E4) and TNF-α-308 G > A genotypes and the RIFLE criteria could be detected. Several multiple linear regression analyses for postoperative creatinine increase revealed highly significant associations for aortic cross clamp time (<italic>p < </italic>0.001), CPB-time (<italic>p < </italic>0.001), norepinephrine (<italic>p < </italic>0.001), left ventricular function (<italic>p = </italic>0.004) and blood transfusion (<italic>p < </italic>0.001). No associations were found for ApoE (E2, E3, E4) and TNF-α-308 G > A genotypes or baseline creatinine. When the sample size is 1415, the multiple linear regression test of <italic>R</italic><sup>2 </sup>= 0 for seven covariates assuming normal distribution will have at least 99% power with significance level 0.05 to detect an <italic>R</italic><sup>2</sup> of 0.108 or 0.107 as observed in the data. <italic>Conclusions</italic>: ApoE (E2, E3, E4) polymorphism and the TNF-α-308 G > A polymorphism are not associated with renal injury after CPB.</p> </abstract>