Increased plasma catalytic iron in patients may mediate acute kidney injury and death following cardiac surgery.
Increased plasma catalytic iron in patients may mediate acute kidney injury and death following cardiac surgery.
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DOI：
10.1038/ki.2014.374
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发表时间：
2015-05
影响因子：
19.6
通讯作者：
中科院分区：
文献类型：
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作者：
催化铁（能够参与氧化还原循环的铁的化学形式）是多种动物模型中急性肾损伤（阿基）的关键介质，但尚未研究其在人类阿基中的作用。在这里，我们在一个由250名接受心脏手术的患者组成的前瞻性队列中测试了血浆催化铁水平是否升高，以及是否与需要肾脏替代治疗的阿基或住院死亡率的综合结局相关。在术前、体外循环结束时以及术后第1天和第3天测量血浆催化铁、游离血红蛋白和其他铁参数。血浆催化铁水平，而不是其他铁参数，显着上升，在心肺转流结束时，并与转流时间和红细胞输注的数量直接相关。在校正年龄和术前eGFR的多变量分析中，术后第1天催化铁水平最高的患者与最低四分位数的患者相比，发生主要结局的几率高6.71，发生阿基、住院死亡率和术后心肌损伤的几率也更高。因此，我们的数据是一致的，并扩大了从动物模型的结果，证明了催化铁在介导不良术后结局的病理作用。作为预防人类阿基的策略，有必要采取旨在降低血浆催化铁水平的干预措施。
Catalytic iron, the chemical form of iron capable of participating in redox cycling, is a key mediator of acute kidney injury (AKI) in multiple animal models, but its role in human AKI has not been studied. Here we tested in a prospective cohort of 250 patients undergoing cardiac surgery whether plasma catalytic iron levels are elevated and associated with the composite outcome of AKI requiring renal replacement therapy or in-hospital mortality. Plasma catalytic iron, free hemoglobin, and other iron parameters were measured preoperatively, at the end of cardiopulmonary bypass, and on postoperative days 1 and 3. Plasma catalytic iron levels, but not other iron parameters, rose significantly at the end of cardiopulmonary bypass and were directly associated with bypass time and number of packed red blood cell transfusions. In multivariate analyses adjusting for age and preoperative eGFR, patients in the highest compared with the lowest quartile of catalytic iron on postoperative day 1 had a 6.71 greater odds of experiencing the primary outcome, and also had greater odds of AKI, hospital mortality, and postoperative myocardial injury. Thus, our data are consistent with and expand on findings from animal models demonstrating a pathologic role of catalytic iron in mediating adverse postoperative outcomes. Interventions aimed at reducing plasma catalytic iron levels as a strategy for preventing AKI in humans are warranted.
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影响因子：
19.6
作者：
Baliga, R;Zhang, ZW;Shah, SV
通讯作者：
Shah, SV
影响因子：
--
作者：
PALLER, MS
通讯作者：
PALLER, MS
影响因子：
37.8
作者：
Donadee C;Raat NJ;Kanias T;Tejero J;Lee JS;Kelley EE;Zhao X;Liu C;Reynolds H;Azarov I;Frizzell S;Meyer EM;Donnenberg AD;Qu L;Triulzi D;Kim-Shapiro DB;Gladwin MT
通讯作者：
Gladwin MT
影响因子：
4.8
作者：
Lele, Suhas S.;Mukhopadhyay, Banibrata N.;Rajapurkar, Mohan M.
通讯作者：
Rajapurkar, Mohan M.
DOI：
10.1016/j.jtcvs.2010.03.028
发表时间：
2010-08-01
影响因子：
6
作者：
Benedetto, Umberto;Angeloni, Emiliano;Sinatra, Riccardo
通讯作者：
Sinatra, Riccardo