Elevated preoperative Galectin-3 is associated with acute kidney injury after cardiac surgery

• Main Authors: Moritz Wyler von Ballmoos, Donald S. Likosky, Michael Rezaee, Kevin Lobdell, Shama Alam, Devin Parker, Sherry Owens, Heather Thiessen-Philbrook, Todd MacKenzie, Jeremiah R. Brown
• Format: Article
• Language: English
• Published: BMC 2018-10-01
• Series: BMC Nephrology
• Subjects: Acute kidney injury (AKI); Galectin-3 (Gal-3); Cardiac surgery; Prediction; Biomarkers
• Online Access: http://link.springer.com/article/10.1186/s12882-018-1093-0

Abstract Background Previous research suggests that novel biomarkers may be used to identify patients at increased risk of acute kidney injury following cardiac surgery. The purpose of this study was to evaluate the relationship between preoperative levels of circulating Galectin-3 (Gal-3) and acute kidney injury after cardiac surgery. Methods Preoperative serum Gal-3 was measured in 1498 patients who underwent coronary artery bypass graft (CABG) surgery and/or valve surgery as part of the Northern New England Biomarker Study between 2004 and 2007. Preoperative Gal-3 levels were measured using multiplex assays and grouped into terciles. Univariate and multinomial logistic regression was used to assess the predictive ability of Gal-3 terciles and AKI occurrence and severity. Results Before adjustment, patients in the highest tercile of Gal-3 had a 2.86-greater odds of developing postoperative KDIGO Stage 2 or 3 (p < 0.001) and 1.70-greater odds of developing KDIGO Stage 1 (p = < 0.001), compared to the first tercile. After adjustment, patients in the highest tercile had 2.95-greater odds of developing KDIGO Stage 2 or 3 (p < 0.001) and 1.71-increased odds of developing KDIGO Stage 1 (p = 0.001), compared to the first tercile. Compared to the base model, the addition of Gal-3 terciles improved discriminatory power compared to without Gal-3 terciles (test of equality = 0.042). Conclusion Elevated preoperative Gal-3 levels significantly improves predictive ability over existing clinical models for postoperative AKI and may be used to augment risk information for patients at the highest risk of developing AKI and AKI severity after cardiac surgery.