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Abstract: SA-PO110

Higher IL-17A Levels Associate with AKI and Correlate with Biomarkers of Kidney Damage

Session Information

Category: Acute Kidney Injury

  • 102 AKI: Clinical, Outcomes, and Trials

Authors

  • Collett, Jason Andrieu, Indiana University School of Medicine, Indianapolis, Indiana, United States
  • Liu, Lucas Jing, University of Kentucky Medical Center, Lexington, Kentucky, United States
  • Flannery, Alexander H., University of Kentucky Medical Center, Lexington, Kentucky, United States
  • Takeuchi, Tomonori, The University of Alabama at Birmingham, Birmingham, Alabama, United States
  • Basile, David P., Indiana University School of Medicine, Indianapolis, Indiana, United States
  • Neyra, Javier A., The University of Alabama at Birmingham, Birmingham, Alabama, United States
Background

AKI is associated with increased morbidity, mortality, and risk of CKD. IL-17A plays an important role in acute injury. We showed that IL-17A levels were elevated in critically ill patients with AKI and associated with hospital mortality and major adverse kidney events. IL-17A may be involved in AKI-to-CKD transition in AKI survivors. We hypothesize that IL-17A levels are elevated in hospitalized patients with AKI at diagnosis, and sustained elevation after discharge is associated with CKD incidence or progression.

Methods

Observational convenience sampling study of hospital survivors of Stage 2 or 3 AKI and controls without AKI from ASSESS-AKI study. Patients were classified as either “progression” or “non-progression” based on a composite of CKD incidence (≥25% decline in eGFR from baseline and achieving CKD stage ≥3), progression (≥25% decline in eGFR from baseline or <15 ml/min) or ESRD. IL-17A levels were evaluated at 0, 3 and 12 months post-AKI, and analyzed along with clinical and biomarker data over a period of up to 84 months.

Results

Among 171 AKI and 175 non-AKI participants, IL-17A levels were significantly elevated in AKI vs. non-AKI patients at 0M, 3M and 12M (p<0.05, Figure). IL-17A levels were significantly elevated in the progression vs. non-progression group, at the 3- and 12-month timepoints for outcomes occurring at 3-6 months and 12-84 months, respectively (p<0.05). In multivariable models that adjusted for demographics, comorbidity, eGFR and albuminuria, there was no independent association between IL-17A levels and the CKD outcome. IL-17A levels were positively correlated with kidney health biomarkers, including UNGAL, UIL-18, TNFa, and TNFRII at all three timepoints (p<0.001).

Conclusion

IL-17A levels were higher in hospital survivors that suffered from AKI when compared to those without AKI from diagnosis to post-discharge follow-up at 3 and 12 months, and according to AKI severity and post-hospitalization status of incident/progressive CKD. IL-17A levels were not independently associated with the CKD outcome but significantly correlated with several biomarkers of kidney health.

Funding

  • NIDDK Support