MicroRNA-21 and risk of severe acute kidney injury and poor outcomes after adult cardiac surgery.
BACKGROUND: Severe acute kidney injury (AKI) after cardiac surgery is associated with poor clinical outcomes. This study evaluated the potential use of miR-21 as a risk marker for postoperative AKI progression and other poor outcomes. METHODOLOGY/PRINCIPAL FINDINGS: The study included 120 adult pati...
Main Authors: | , , , , , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
Public Library of Science (PLoS)
2013-01-01
|
Series: | PLoS ONE |
Online Access: | http://europepmc.org/articles/PMC3662667?pdf=render |
id |
doaj-af859432ab9c462c8071f9befb3908f6 |
---|---|
record_format |
Article |
spelling |
doaj-af859432ab9c462c8071f9befb3908f62020-11-25T02:33:31ZengPublic Library of Science (PLoS)PLoS ONE1932-62032013-01-0185e6339010.1371/journal.pone.0063390MicroRNA-21 and risk of severe acute kidney injury and poor outcomes after adult cardiac surgery.Juan DuXiaoqing CaoLiang ZouYi ChenJin GuoZujun ChenShengshou HuZhe ZhengBACKGROUND: Severe acute kidney injury (AKI) after cardiac surgery is associated with poor clinical outcomes. This study evaluated the potential use of miR-21 as a risk marker for postoperative AKI progression and other poor outcomes. METHODOLOGY/PRINCIPAL FINDINGS: The study included 120 adult patients undergoing cardiac surgery: 40 non-AKI controls, 39 patients with progressive AKI, and 41 with non-progressive AKI. Urine and plasma levels of miR-21 were assessed by quantitative real-time PCR (RT-qPCR). Associations between miR-21 levels and AKI progression were determined by estimating areas under receiver operating characteristic curves (AUC). We demonstrated that up-regulated urine and plasma levels of miR-21 in patients with AKI were both associated with AKI progression. The AUCs for urine and plasma levels of miR-21 associated with established AKI were 0.68 (95%CI: 0.59-0.78) and 0.80 (95%CI: 0.73-0.88), respectively. Multiple logistic regression analysis, adjusting for clinical variables, indicated that the prognostic predictive power of urine and plasma miR-21 levels for AKI progression were represented by AUCs of 0.81 (95%CI: 0.72-0.91) and 0.83 (95%CI: 0.74-0.92), respectively. Urinary and plasma miR-21 levels also predicted the need for postoperative renal replacement therapy (RRT), development of Acute Kidney Injury Network (AKIN) stage 3 AKI, 30-day in-hospital mortality and prolonged stay in hospital or ICU. Urine miR-21 was a better outcome predictor than plasma miR-21, being associated with higher (1.4- to 2.6-fold) unadjusted odds ratio for progression of AKI and other poor outcomes. CONCLUSIONS: Urinary and plasma miR-21 are associated with severe AKI and other poor postoperative outcomes of cardiac surgery, indicating their potential use as prognostic markers.http://europepmc.org/articles/PMC3662667?pdf=render |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Juan Du Xiaoqing Cao Liang Zou Yi Chen Jin Guo Zujun Chen Shengshou Hu Zhe Zheng |
spellingShingle |
Juan Du Xiaoqing Cao Liang Zou Yi Chen Jin Guo Zujun Chen Shengshou Hu Zhe Zheng MicroRNA-21 and risk of severe acute kidney injury and poor outcomes after adult cardiac surgery. PLoS ONE |
author_facet |
Juan Du Xiaoqing Cao Liang Zou Yi Chen Jin Guo Zujun Chen Shengshou Hu Zhe Zheng |
author_sort |
Juan Du |
title |
MicroRNA-21 and risk of severe acute kidney injury and poor outcomes after adult cardiac surgery. |
title_short |
MicroRNA-21 and risk of severe acute kidney injury and poor outcomes after adult cardiac surgery. |
title_full |
MicroRNA-21 and risk of severe acute kidney injury and poor outcomes after adult cardiac surgery. |
title_fullStr |
MicroRNA-21 and risk of severe acute kidney injury and poor outcomes after adult cardiac surgery. |
title_full_unstemmed |
MicroRNA-21 and risk of severe acute kidney injury and poor outcomes after adult cardiac surgery. |
title_sort |
microrna-21 and risk of severe acute kidney injury and poor outcomes after adult cardiac surgery. |
publisher |
Public Library of Science (PLoS) |
series |
PLoS ONE |
issn |
1932-6203 |
publishDate |
2013-01-01 |
description |
BACKGROUND: Severe acute kidney injury (AKI) after cardiac surgery is associated with poor clinical outcomes. This study evaluated the potential use of miR-21 as a risk marker for postoperative AKI progression and other poor outcomes. METHODOLOGY/PRINCIPAL FINDINGS: The study included 120 adult patients undergoing cardiac surgery: 40 non-AKI controls, 39 patients with progressive AKI, and 41 with non-progressive AKI. Urine and plasma levels of miR-21 were assessed by quantitative real-time PCR (RT-qPCR). Associations between miR-21 levels and AKI progression were determined by estimating areas under receiver operating characteristic curves (AUC). We demonstrated that up-regulated urine and plasma levels of miR-21 in patients with AKI were both associated with AKI progression. The AUCs for urine and plasma levels of miR-21 associated with established AKI were 0.68 (95%CI: 0.59-0.78) and 0.80 (95%CI: 0.73-0.88), respectively. Multiple logistic regression analysis, adjusting for clinical variables, indicated that the prognostic predictive power of urine and plasma miR-21 levels for AKI progression were represented by AUCs of 0.81 (95%CI: 0.72-0.91) and 0.83 (95%CI: 0.74-0.92), respectively. Urinary and plasma miR-21 levels also predicted the need for postoperative renal replacement therapy (RRT), development of Acute Kidney Injury Network (AKIN) stage 3 AKI, 30-day in-hospital mortality and prolonged stay in hospital or ICU. Urine miR-21 was a better outcome predictor than plasma miR-21, being associated with higher (1.4- to 2.6-fold) unadjusted odds ratio for progression of AKI and other poor outcomes. CONCLUSIONS: Urinary and plasma miR-21 are associated with severe AKI and other poor postoperative outcomes of cardiac surgery, indicating their potential use as prognostic markers. |
url |
http://europepmc.org/articles/PMC3662667?pdf=render |
work_keys_str_mv |
AT juandu microrna21andriskofsevereacutekidneyinjuryandpooroutcomesafteradultcardiacsurgery AT xiaoqingcao microrna21andriskofsevereacutekidneyinjuryandpooroutcomesafteradultcardiacsurgery AT liangzou microrna21andriskofsevereacutekidneyinjuryandpooroutcomesafteradultcardiacsurgery AT yichen microrna21andriskofsevereacutekidneyinjuryandpooroutcomesafteradultcardiacsurgery AT jinguo microrna21andriskofsevereacutekidneyinjuryandpooroutcomesafteradultcardiacsurgery AT zujunchen microrna21andriskofsevereacutekidneyinjuryandpooroutcomesafteradultcardiacsurgery AT shengshouhu microrna21andriskofsevereacutekidneyinjuryandpooroutcomesafteradultcardiacsurgery AT zhezheng microrna21andriskofsevereacutekidneyinjuryandpooroutcomesafteradultcardiacsurgery |
_version_ |
1724813487235923968 |