MicroRNA-21 and risk of severe acute kidney injury and poor outcomes after adult cardiac surgery.

PLoS One

State Key Laboratory of Cardiovascular Medicine, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China.

Published: January 2014

AI Article Synopsis

  • The study investigated miR-21 levels in 120 patients undergoing cardiac surgery to evaluate its effectiveness as a risk marker for acute kidney injury (AKI) and poor clinical outcomes.
  • Results showed that elevated miR-21 levels in both urine and plasma were linked to AKI progression, with urine miR-21 being a stronger predictor of adverse outcomes like severe AKI and longer hospital stays.
  • The findings suggest that monitoring miR-21 can help predict AKI severity and related complications post-surgery, highlighting its potential as a useful prognostic tool in clinical settings.

Article Abstract

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.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3662667PMC
http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0063390PLOS

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