Abstract 12622: Pro-inflammatory Urinary CXCL10 and VCAM Are Elevated After Infant Cardiac Surgery-associated Acute Kidney Injury (AKI)

• Published in: Circulation (New York, N.Y.) Vol. 142; no. Suppl_3 Suppl 3; p. A12622
• Main Authors: Levy- Erez, Daniella, Shah, Lokesh, Howarth, Kathryn D, Meloni, Sherin, Laskin, Benjamin, Sullivan, Kathleen E, BLINDER, Joshua J
• Format: Journal Article
• Language: English
• Published: by the American College of Cardiology Foundation and the American Heart Association, Inc 17-11-2020
• ISSN: 0009-7322; 1524-4539
• DOI: 10.1161/circ.142.suppl_3.12622

IntroductionAcute kidney injury (AKI) occurs frequently after infant cardiac surgery and is associated with mortality. AKI mechanisms are unknown, limiting therapeutic targets. Emerging data implicates unregulated immune activation and AKI development. HypothesisUrinary immune biomarkers will be elevated in the urine of infants developing AKI. MethodsOne hundred and twenty six infants were enrolled (median age 87 days, 74% male). Urine samples were collected pre-bypass and 6, 24, 48, and 72 hours after surgery. Urine samples underwent multiplex Luminex assays to detect six immune biomarkersVCAM, CXCL10, MCP, IL-18, TWEAK, and C5-C9. Greater than 150% increase in serum creatinine defined AKI. The Kruskal-Wallis rank test determined the relationship between AKI and biomarker levels. ResultsThirty-five infants (27%) developed AKI. AKI subjects were younger (median 6 days (4-98) vs no AKI 107 days (7-164), p<0.01). The AKI group had more complex surgery (STAT 4-5) (60% AKI vs 19% no AKI, p<0.01). Bypass time was longer among the AKI group ((81 min vs 69 min (p<0.01)).AKI infants had higher urinary CXCL10 levels at 24 hours (14.3 pg/ml vs 5.3 pg/ml p=0.04), 48 hours (3.4 pg/ml vs 0.75 pg/ml p=0.01), and 72 hours (1.15 pg/ml vs 0.22 pg/ml p=0.05) (Figure 1). Six-hour VCAM levels were higher among AKI infants (Median 491 pg/ml vs 0 pg/ml p=0.04). Other biomarkers showed no significant differences between groups. (Table1). ConclusionsUrinary CXCL10 and VCAM are promising pro-inflammatory biomarkers for early AKI detection and may indicate eventual AKI therapeutic targets.