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Kidney Week

Abstract: TH-PO051

Heat Shock Protein 72 (Hsp72) Is a Useful Biomarker for AKI in Liver Transplant

Session Information

Category: Acute Kidney Injury

  • 101 AKI: Epidemiology, Risk Factors, and Prevention

Authors

  • Martinez-Rueda, Armando Jezael, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
  • Bazua-Valenti, Silvana, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
  • Olivas-Martínez, Antonio, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
  • Jimenez, Jose Víctor, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
  • Carrillo Perez, Diego Luis, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
  • Grajeda-Medina, Leoneli I., Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
  • Ortega-Trejo, Juan Antonio, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
  • Sanchez-Navarro, Andrea, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
  • Pérez-villalva, Rosalba, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
  • García juárez, Ignacio, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
  • Morales-Buenrostro, Luis E., Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
  • Bobadilla, Norma, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
  • Gamba, Gerardo, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
Background

Acute Kidney Injury (AKI) after liver transplantation (LT) is a frequent complication and an important risk factor for mortality. We have shown that Hsp72 is an early AKI biomarker in animal models of ischemic acute renal injury and in a variety of critically ill patients in the ICU (EMBO MM 2011 and Plos One 2014). Since the LT program in our institute performs one transplant per week, we designed the present study to determine the incidence and risk factors of AKI during the postoperative period of LT, and to assess whether Hsp72 can be a useful tool to predict AKI.

Methods

We conducted a single-center prospective and observational study for LT patients (N=26). AKI was defined as a two-fold increase in baseline serum creatinine (SCr). Urine samples were collected before LT and at 0, 6, 12, 24 and 48 hours after. Urinary samples were resolved in SDS-PAGE gels and analyzed by western blot with a monoclonal anti-Hsp72 antibody. Hsp72 values were adjusted to urinary creatinine concentration.

Results

The mean age of our cohort was 49±10.58 years with 57.7% females. Hepatitis C infection was the main etiology for cirrhosis (42.3%). 14 patients (53.8%) developed AKI in the 5 days post-LT, and four of them required dialysis. Multivariate analysis showed that AKI was associated with encephalopathy prior to LT (OR 10.99, p=0.029). Based on SCr, AKI was diagnosed with a median of 24 h post-LT. Conversely, Hsp72 levels significantly increased at 6 h post-LT in patients that developed AKI vs. the non-AKI (p=0.042). The AUC-ROC analysis revealed that at 6 h Hsp72 predicts AKI with an AUC of 0.732.

Conclusion

Our observations indicate that urinary Hsp72 increases in patients that develop AKI in the post-LT several hours before they reach AKI criteria based on SCr, suggesting that Hsp72 could be a useful biomarker for the development of AKI.

Funding

  • Government Support - Non-U.S.