Year: 2025
Type: article
Abstract: Background Endogenous measures of impaired kidney tubule secretion associate with kidney function decline. Whether they also associate with future acute kidney injury (AKI) risk is unclear. Methods In 397 participants of the Reasons for Geographic and Racial Differences in Stroke study who underwent coronary artery bypass graft (CABG) surgery (mean age 66, 29% female), we examined the association of a summary secretion score of 11 endogenous secretion markers (measured a median 5.5 years before CABG) with AKI risk following CABG, adjusting for confounders including estimated glomerular filtration rate (eGFR) and albuminuria. Results A total of 177 participants developed AKI (≥0.3 mg/dL or 1.5x creatinine increase) following CABG. Individuals who developed AKI were older, more likely to be men, have diabetes, lower eGFR and greater albuminuria at the baseline visit. In models adjusted for age, sex, race, urine creatinine, time from baseline to CABG, diabetes, hypertension and BMI, a higher (signifying better) secretion score was associated with lower risk of AKI (RR comparing 4 th to 1 st quartile 0.49, 95%CI 0.32,0.74). The results did not meaningfully differ after further adjusting for eGFR and albuminuria (RR 0.58, 95%CI 0.38,0.89), or when secretion score was analyzed as a continuous variable (RR per 1 SD higher score 0.85, 95%CI 0.71,1.01). Associations were stronger in women (RR 0.75, 95%CI 0.59,0.95) than men (RR 0.89, 95%CI 0.69,1.16) in fully adjusted models ( P interaction =0.01). Conclusion In community-based adults, greater estimated tubular secretion at times of relative health is associated with lower risk of AKI following CABG.
Source: Kidney International Reports
Institutions: University of Alabama at Birmingham, The Ohio State University, University of California San Diego, VA San Diego Healthcare System, Wake Forest University Health Sciences, Wake Forest University, VA Tennessee Valley Healthcare System, Nashville VA Medical Center, Vanderbilt University Medical Center, San Francisco VA Medical Center, University of California, San Francisco, San Francisco VA Health Care System, Brigham and Women's Hospital, Harvard University, University of Minnesota
Language: English
Topic: Acute Kidney Injury Research
Subfield: Nephrology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,800
Funders: U.S. Department of Defense, U.S. Department of Health and Human Services, Abbott Laboratories, Amgen, AstraZeneca, University of Pittsburgh, University of Alabama, Akebia Therapeutics, National Institutes of Health, National Institute on Aging, National Heart, Lung, and Blood Institute, National Institute of Diabetes and Digestive and Kidney Diseases, National Institute of Neurological Disorders and Stroke
OpenAlex ID: W7117131553