Effect of polymorphisms of lanosterol synthase gene on the development of AKI after cardiac surgery

12^th Global Nephrologists Annual Meeting

June 26-28, 2017 London, UK

Paolo Manunta, Marco Simonini, Simona Pozzoli, Elena Bignami, Chiara Lanzani, Nunzia Casamassima, Elisabetta Messaggio, Lorena Citterio and Paolo Manunta

San Raffaele University School of Medicine, Italy

Posters & Accepted Abstracts: J Nephrol Ther

Abstract :

Background & Aim: Acute kidney injury (AKI) is an important complication of cardiac surgery. Elevated circulating endogenous ouabain (EO), an adrenal stress hormone with haemodynamic and renal effects, has been associated with worse renal outcome after cardiac surgery. Our group has reported how the activity of EO is partly linked to the allelic variants of genes involved in its synthesis (as lanosterol synthase (LSS). The aim of this work is to investigate the relationship between this gene and the development of AKI after cardiac surgery. Methods: 1100 patients, undergoing elective cardiac surgery at our Hospital, were genotyped. Primary outcome was AKI according to Acute Kidney Injury Network. Secondary outcomes were length of ICU stay and total in-hospital mortality. Total AKI incidence (AKIN stage I or higher) was 22.2%. Results: No difference in basal EO levels was observed according to LSS allelic variation. Patients carrying the less common variant of the LSS polymorphism had a more severe clinical presentation, expressed as higher EuroSCORE (5.38�±5.81 vs. 4.83�±3.22 vs. 3.73�±1.18; p=0.002). Likewise, according to LSS polymorphisms, AKI incidence was 30.7% vs. 26.0% vs. 17.4% (p=0.001). However, even after adjustment for the main covariates (sex, age, basal eGFR, baseline EF, presence of hypertension or DM, type or difficulty of surgical procedure and pre-operative value of EuroSCORE) LSS was still significant (�² 0.71, Exp(B) 2.03 (IC 95% 1.29-3.21); p=0.002. Conclusion: Patients with at least one mutated gene polymorphism LSS have a greater chance of developing acute kidney injury after cardiac surgery, despite on clinical presentation.

Biography :

Email: paolo.gontero@unito.it