High preoperative serum strontium levels increase the risk of acute kidney injury after cardiopulmonary bypass
High preoperative serum strontium levels increase the risk of acute kidney injury after cardiopulmonary bypass
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DOI：
10.1007/s10157-022-02314-w
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发表时间：
2023-01
影响因子：
2.3
通讯作者：
Natsumi Tomita;Y. Hotta;Hidekazu Ito;A. Naiki‐Ito;Karin Matsuta;Y. Yamamoto;K. Ohashi;Tomoaki Hayakawa;A. Sanagawa;Y. Horita;M. Kondo;T. Kataoka;Satoru Takahashi;K. Sobue;K. Kimura
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作者：
Natsumi Tomita;Y. Hotta;Hidekazu Ito;A. Naiki‐Ito;Karin Matsuta;Y. Yamamoto;K. Ohashi;Tomoaki Hayakawa;A. Sanagawa;Y. Horita;M. Kondo;T. Kataoka;Satoru Takahashi;K. Sobue;K. Kimura
研究背景急性肾损伤（Acute kidney injury，阿基）是心脏手术的常见并发症.使用心肺转流（CPB-AKI）的心脏手术后阿基的发生率很高，强调需要确定预防CPB-AKI的策略。本研究探讨CPB-AKI和微量金属水平在临床和动物study.MethodsSamples和临床数据之间的相关性，从74例患者从名古屋市立大学医院和冈崎市立医院。在CPB停药前、停药后即刻和停药后2 h采集血样。使用电感耦合等离子体质谱法测量痕量金属水平。将Sr或媒介物治疗经口给予大鼠以确定Sr是否与CPB-AKI相关。治疗结束后，观察CPB-AKI的发生率，并检测血清肌酐（SCr）和尿素氮（BUN）水平。阿基患者的体重指数和估计的肾小球滤过率有显著差异。阿基患者的重症监护室和住院时间长于非AKI患者。CPB前阿基患者的Na、Fe和Sr水平显著较高。阿基患者停CPB后即刻Fe和Sr升高，停CPB后2 h Sr升高。动物研究表明，锶治疗的大鼠有显着增加SCr和BUN水平比车辆治疗的大鼠在24小时后IR injure.ConclusionsHigh术前血清锶水平可能与CPB-AKI。
BackgroundAcute kidney injury (AKI) is a common complication of cardiac surgeries. The incidence of AKI after cardiac surgeries using cardiopulmonary bypass (CPB-AKI) is high, emphasizing the need to determine strategies to prevent CPB-AKI. This study investigates the correlation between CPB-AKI and trace metal levels in clinical and animal studies.MethodsSamples and clinical data were obtained from 74 patients from the Nagoya City University Hospital and Okazaki City Hospital. Blood samples were collected before, immediately after, and 2 h after CPB withdrawal. Trace metal levels were measured using inductively coupled plasma mass spectrometry. Sr or vehicle treatment was orally administered to the rats to determine if Sr was associated with CPB-AKI. After the treatment, ischemia–reperfusion (IR) injury was induced, and serum creatinine (SCr) and blood urea nitrogen (BUN) levels were measured.ResultsIn this clinical study, the incidence of CPB-AKI was found to be 28% (21/74). The body mass index and estimated glomerular filtration rate were significantly different in patients with AKI. The intensive care unit and hospital stay were longer in AKI patients than in non-AKI patients. The Na, Fe, and Sr levels were significantly higher in AKI patients before CPB. Also, Fe and Sr were higher immediately after CPB withdrawal, and Sr was higher 2 h after CPB withdrawal in AKI patients. Animal studies showed that Sr-treated rats had significantly increased SCr and BUN levels than vehicle-treated rats at 24 h post-IR injury.ConclusionsHigh preoperative serum Sr levels may be associated with CPB-AKI.