Apolipoprotein E genotype, TNF-α 308G/A and risk for cardiac surgery associated-acute kidney injury in Caucasians

Ren Fail. 2014 Mar;36(2):237-43. doi: 10.3109/0886022X.2013.835267. Epub 2013 Sep 24.

Abstract

Objectives: Acute kidney injury following cardiac surgery depicts a severe clinical problem that is strongly associated with adverse short- and long-term outcome. We analyzed two common genetic polymorphisms that have previously been linked to renal failure and inflammation, and have been supposed to be associated with cardiac surgery associated-acute kidney injury (CSA-AKI).

Methods: A total of 1415 consecutive patients who underwent elective cardiac surgery with CPB at our institution were prospectively enrolled. Patients were genotyped for Apolipoprotein E (ApoE E2,E3,E4) (rs429358 and rs7412) and TNF-α-308 G > A (rs1800629).

Results: Demographic characteristics and procedural data revealed no significant differences between genotypes. No association between ApoE (E2,E3,E4) and TNF-α-308 G > A genotypes and the RIFLE criteria could be detected. Several multiple linear regression analyses for postoperative creatinine increase revealed highly significant associations for aortic cross clamp time (p < 0.001), CPB-time (p < 0.001), norepinephrine (p < 0.001), left ventricular function (p = 0.004) and blood transfusion (p < 0.001). No associations were found for ApoE (E2,E3,E4) and TNF-α-308 G > A genotypes or baseline creatinine. When the sample size is 1415, the multiple linear regression test of R(2 )= 0 for seven covariates assuming normal distribution will have at least 99% power with significance level 0.05 to detect an R(2) of 0.108 or 0.107 as observed in the data.

Conclusions: ApoE (E2,E3,E4) polymorphism and the TNF-α-308 G > A polymorphism are not associated with renal injury after CPB.

MeSH terms

  • Acute Kidney Injury / etiology*
  • Acute Kidney Injury / physiopathology
  • Aged
  • Aorta
  • Apolipoprotein E2 / genetics
  • Apolipoprotein E3 / genetics
  • Apolipoprotein E4 / genetics
  • Apolipoproteins E / genetics*
  • Blood Transfusion
  • Cardiopulmonary Bypass / adverse effects*
  • Cardiopulmonary Bypass / methods
  • Constriction
  • Creatinine / blood
  • Female
  • Genotype*
  • Humans
  • Male
  • Middle Aged
  • Norepinephrine / blood
  • Operative Time
  • Polymorphism, Single Nucleotide*
  • Prospective Studies
  • Stroke Volume
  • Tumor Necrosis Factor-alpha / genetics*

Substances

  • Apolipoprotein E2
  • Apolipoprotein E3
  • Apolipoprotein E4
  • Apolipoproteins E
  • Tumor Necrosis Factor-alpha
  • Creatinine
  • Norepinephrine