The () Promoter Polymorphisms (rs3063368, rs755622) Predict Acute Kidney Injury and Death after Cardiac Surgery.

Background: Macrophage Migration Inhibitory Factor (MIF) is highly elevated after cardiac surgery and impacts the postoperative inflammation. The aim of this study was to analyze whether the polymorphisms CATT (rs5844572/rs3063368,"-794") and G>C single-nucleotide polymorphism (rs755622,-173) in the gene promoter are related to postoperative outcome.

Methods: In 1116 patients undergoing cardiac surgery, the gene polymorphisms were analyzed and serum MIF was measured by ELISA in 100 patients.

Results: Patients with at least one extended repeat allele (CATT) had a significantly higher risk of acute kidney injury (AKI) compared to others (23% vs. 13%; OR 2.01 (1.40-2.88), = 0.0001). Carriers of CATT were also at higher risk of death (1.8% vs. 0.4%; OR 5.12 (0.99-33.14), = 0.026). The GC genotype was associated with AKI (20% vs. GG/CC:13%, OR 1.71 (1.20-2.43), = 0.003). Multivariate analyses identified CATT predictive for AKI (OR 2.13 (1.46-3.09), < 0.001) and death (OR 5.58 (1.29-24.04), = 0.021). CATT was associated with higher serum MIF before surgery (79.2 vs. 50.4 ng/mL, = 0.008).

Conclusion: The CATT allele associates with a higher risk of AKI and death after cardiac surgery, which might be related to chronically elevated serum MIF. Polymorphisms in the gene may constitute a predisposition for postoperative complications and the assessment may improve risk stratification and therapeutic guidance.