Abstract: FR-PO0063
Markers of Kidney Tubule Dysfunction Are Associated with Future Risk of AKI Following Cardiac Surgery
Session Information
- AKI: Epidemiology, Risk Factors, and Prevention
November 07, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Acute Kidney Injury
- 101 AKI: Epidemiology, Risk Factors, and Prevention
Authors
- Shingler, Lauren, The Ohio State University Wexner Medical Center, Columbus, Ohio, United States
- Tamhane, Ashutosh, The University of Alabama at Birmingham, Birmingham, Alabama, United States
- Gutierrez, Orlando M., The University of Alabama at Birmingham, Birmingham, Alabama, United States
- Ix, Joachim H., University of California San Diego, La Jolla, California, United States
- Frey, Jennifer A., The Ohio State University Wexner Medical Center, Columbus, Ohio, United States
- Levitan, Emily B., The University of Alabama at Birmingham, Birmingham, Alabama, United States
- Judd, Suzanne E., The University of Alabama at Birmingham, Birmingham, Alabama, United States
- Bullen, Alexander L., University of California San Diego, La Jolla, California, United States
- Siew, Edward D., Vanderbilt University School of Medicine, Nashville, Tennessee, United States
- Bonventre, Joseph V., Brigham and Women's Hospital, Boston, Massachusetts, United States
- Shlipak, Michael, San Francisco VA Health Care System, San Francisco, California, United States
- Jaeger, Byron C., Wake Forest University School of Medicine, Winston-Salem, North Carolina, United States
- Seegmiller, Jesse C., University of Minnesota Twin Cities, Minneapolis, Minnesota, United States
- Chu, Ching Min Bryan, The Ohio State University Wexner Medical Center, Columbus, Ohio, United States
- Keister, Alexander, The Ohio State University Wexner Medical Center, Columbus, Ohio, United States
- Wang, Henry E., The Ohio State University Wexner Medical Center, Columbus, Ohio, United States
Background
Acute kidney injury (AKI) is common after coronary artery bypass graft (CABG) surgery, but it is unclear why some individuals are at higher risk of AKI following CABG than others. We evaluated if biomarkers of kidney tubule dysfunction and injury are associated with long-term risk of post-CABG AKI.
Methods
We performed a nested cohort study using data from the REasons for Geographic And Racial Differences in Stroke (REGARDS) study, a longitudinal cohort of 30,239 adults ≥45 years age. We identified all hospitalizations for CABG surgery between 2003 and 2015. We measured 4 biomarkers reflecting kidney tubule function and injury (urinary alpha-1 microglobulin (A1M), uromodulin (UMOD), epidermal growth factor (EGF) and kidney injury molecule-1 (KIM-1)) in samples collected at a baseline. We defined AKI as a ≥0.3 mg/dL serum creatinine (sCr) increase between the lowest sCr value within 48 hours prior to the CABG surgery to the highest sCr during the remainder of abstracted hospitalization. Using logistic regression, we determined the associations between increased tubule function and injury markers and post-CABG AKI, adjusted for demographics, clinical variables, eGFR and albuminuria.
Results
Of the 30,239 REGARDS participants, 397 underwent CABG (mean age 66, 29% female, 20% Black). Median time to CABG was 5.5 years. Of the CABG cases, 179 (45%) experienced post-surgery AKI. Increased A1M was associated with higher adjusted odds of AKI following CABG (adjusted OR 1.34 per 2-fold increase, 95% Confidence Interval (CI): 1.00–1.79). Higher UMOD and EGF were associated with lower odds of AKI (adjusted OR 0.75 per 2-fold increase, 95% CI 0.61–0.93 and 0.78, 95% CI 0.58–1.04, respectively). KIM-1 was not associated with AKI (adjusted OR 0.92, 95% CI 0.77–1.10).
Conclusion
Baseline biomarkers of tubule function are associated with future post-CABG AKI. Subtle abnormalities in tubule function may identify individuals at risk for AKI when subjected to a kidney stressor like CABG surgery.
Funding
- NIDDK Support