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Abstract: SA-PO064

Is Reduced Telomere Length Associated with an Increased Risk of AKI Following Cardiac Surgery?

Session Information

Category: Acute Kidney Injury

  • 003 AKI: Clinical and Translational


  • Balmforth, Damian C, William Harvey Research Institute, London, United Kingdom
  • Muthuppalaniappan, Vasantha M., William Harvey Research Institute, London, United Kingdom
  • Duraisingham, Sai Krishna, William Harvey Research Institute, London, United Kingdom
  • Harwood, Steven Michael, William Harvey Research Institute, London, United Kingdom
  • Kieswich, Julius Edward, William Harvey Research Institute, London, United Kingdom
  • Uppal, Rakesh, Barts and the London NHS Trust, London, United Kingdom
  • Yaqoob, Muhammad M., William Harvey Research Institute, London, United Kingdom

Patients undergoing cardiopulmonary bypass are at risk of post-operative acute kidney injury (AKI) due to renal ischemia. Several studies have demonstrated an association between cardiac surgery associated-AKI (CSA-AKI) and reduced long-term survival which persists even when the degree of AKI is mild and where there is complete resolution of the injury prior to discharge. The mechanism by which CSA-AKI is associated with increased mortality is not currently understood. Telomere length has been proposed as a biomarker for cellular senescence and aging and shortened telomeres have been shown to delay recovery after ischemia induced renal injury in animal models. We hypothesised that patients with reduced telomere length undergoing cardiac surgery may have increased long-term mortality and be more susceptible to ischemia-induced AKI.


Blood samples were taken immediately prior to surgery and mean leukocyte telomere length (TL) measured by quantitative real time polymerase chain reaction (rt-PCR). The primary outcome was the development of AKI in the first 7 days post-operatively, defined by the Adult Kidney Injury Network (AKIN) criteria. All patients were entered into a study database that recorded a range of pre-operative, intra-operative, and post-operative variables. Univariate statistical analysis was performed.


Between January 2016 and March 2017, 243 patients at a single institution were recruited. Of these, 51 developed post-operative AKI (21%) as defined by the AKIN criteria (stage 1 = 45; stage 2 = 6; stage 3 = 4). No differences were found between the AKI and non-AKI groups in terms of male gender (79.4% Vs 79.4%; p = 1), mean age (67.0 Vs 63.1 years; p = 0.061), or ethnicity ( p = 0.223). As expected, mean length of stay was significantly longer in the AKI group at 14.8 days compared to 9.3 days in the non-AKI group (p <0.0001). No difference in mean telomere length was found between the groups with a mean relative TL of 0.73 and 0.76 in the AKI and non-AKI groups respectively (p = 0.334).


No association was found between mean telomere length and the development of AKI following cardiac surgery.