Apolipoprotein E genotype, TNF-α 308G/A and risk for cardiac surgery associated-acute kidney injury in Caucasians.
OBJECTIVE
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.
Klinik fuer Herz- und Gefaesschirurgie, Deutsches Herzzentrum Muenchen, Technische Universitaet Muenchen, Munich Heart Alliance , Munich , Germany and.
Johannes
J
Boehm
Stefan
S
Eichhorn
Matthias
M
Kornek
Katharina
K
Hauner
Anatol
A
Prinzing
Joachim
J
Grammer
Harald
H
Lahm
Stefan
S
Wagenpfeil
Ruediger
R
Lange
D058186:Acute Kidney Injury / Q000209:etiology* / Q000503:physiopathology; D000368:Aged; D001011:Aorta; D053329:Apolipoprotein E2 / Q000235:genetics; D053318:Apolipoprotein E3 / Q000235:genetics; D053327:Apolipoprotein E4 / Q000235:genetics; D001057:Apolipoproteins E / Q000235:genetics*; D001803:Blood Transfusion; D002315:Cardiopulmonary Bypass / Q000009:adverse effects* / Q000379:methods; D003250:Constriction; D003404:Creatinine / Q000097:blood; D005260:Female; D005838:Genotype; D006801:Humans; D008297:Male; D008875:Middle Aged; D009638:Norepinephrine / Q000097:blood; D061646:Operative Time; D020641:Polymorphism, Single Nucleotide; D011446:Prospective Studies; D013318:Stroke Volume; D014409:Tumor Necrosis Factor-alpha / Q000235:genetics*
D053329:Apolipoprotein E2; D053318:Apolipoprotein E3; D053327:Apolipoprotein E4; D001057:Apolipoproteins E; D014409:Tumor Necrosis Factor-alpha; D003404:Creatinine; D009638:Norepinephrine