Abstract: FR-PO0060
Urine Metabolome Profiling Identifies Early Metabolite Signatures of Cardiac Surgery-Associated AKI
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
- Lee, Cheng chia, Linkou Chang Gung Memorial Hospital, Taoyuan, Taoyuan City, Taiwan
- Chang, Chih-Hsiang, Linkou Chang Gung Memorial Hospital, Taoyuan, Taoyuan City, Taiwan
- Chan, Ming-Jen, Linkou Chang Gung Memorial Hospital, Taoyuan, Taoyuan City, Taiwan
Background
Cardiac surgery–associated acute kidney injury (CS-AKI) is a serious and common complication following cardiac surgery; however, progress in early detection and effective intervention remains limited. Given the kidneys' high metabolic activity and the significant metabolic disturbances associated with AKI, metabolomic profiling represents a powerful strategy to identify novel biomarkers and therapeutic targets.
Methods
We performed an untargeted metabolomics analysis on urine samples collected during the first 4 hours postoperatively from 55 patients who underwent cardiac surgery (non-AKI: 26, AKI: 29). Metabolomic profiling was performed using a high-performance chemical isotope labeling liquid chromatography-mass spectrometry (LC-MS) method. AKI was defined based on KDIGO criteria.
Results
The urine metabolomic profiles of CS-AKI patients differed significantly from those of non-AKI patients. We identified 45 significantly differentially expressed metabolites associated with AKI development (defined by a fold change beyond the mean ± 2 standard deviations). After excluding non-endogenous compounds, we ultimately identified 10 metabolites that matched known compounds and significantly differed between AKI and non-AKI patients (Figure 1). The top annotated metabolite is N-Acetylputrescine, which demonstrated an AUC of 0.881 in distinguishing AKI from non-AKI. Additionally, three other polyamine catabolites—N1-acetylspermidine, N8-acetylspermidine, and N1,8-diacetylspermidine—were found to be elevated in AKI patients, suggesting upregulation of polyamine catabolism during AKI. Furthermore, the levels of several identified metabolites, including N-Acetylputrescine, showed significant correlation with AKI severity, as defined by non-AKI, mild AKI (stages 1 and 2), and severe AKI (stage 3)
Conclusion
Urine metabolomic profiling effectively distinguishes AKI from non-AKI following cardiac surgery, reveals key metabolite alterations, and supports its potential as a non-invasive tool for the early diagnosis of CS-AKI.