title: Surfactant protein-D (SP-D) gene polymorphisms and serum level as predictors of susceptibility and prognosis of acute kidney injury in the Chinese population.
abstract: Injury to the kidney epithelial barrier is a characteristic feature of acute kidney injury (AKI). Serum surfactant protein-D (SP-D), a known biomarker of damaged alveolar epithelium, is also secreted by renal tubular epithelial cells. Therefore, the aim of this study was to examine the possible association of SP-D with AKI susceptibility and prognosis.
  
  
  
  In this study, 159 AKI patients and 120 healthy individuals were included. SP-D polymorphisms Thr11Met and Thr160Ala, AKI patient serum SP-D levels at days 1, 3 and 7 and urine KIM-1 levels in both AKI patients and controls were examined. The obtained results were correlated with the AKI stage, duration of renal replacement therapy (RRT) and prognosis.
  
  
  
  Serum SP-D level in AKI patients was higher than controls (p < 0.01). SP-D 11Thr/Thr genotype was more frequent in AKI patients than in controls (p < 0.01). Furthermore, AKI patients with SP-D 11Thr/Thr genotype had significantly higher serum SP-D levels (p < 0.05) compared to other genotypes. Serum SP-D levels corrected to the progression of AKI with a peak at day 3. Furthermore, the SP-D 11Thr/Thr genotype frequency and baseline serum SP-D level were higher in patients who subsequently died. Baseline serum SP-D levels positively correlated with the urine KIM-1 levels, AKI stage and RRT duration.
  
  
  
  In our study, elevated serum SP-D was associated with worse AKI clinical outcomes and patients with SP-D 11Thr/Thr genotype were more susceptible to AKI. Collectively, these findings suggest that SP-D may be useful as a biomarker of AKI susceptibility and prognosis.
authors.affiliation: Department of Critical Care Medicine, Renmin Hospital of Wuhan University, Wuhan, Hubei, 430060, China.
authors.forename: Jiao
authors.initials: J
authors.lastname: Liu
authors.affiliation: Department of Critical Care Medicine, Renmin Hospital of Wuhan University, Wuhan, Hubei, 430060, China.
authors.forename: Guang
authors.initials: G
authors.lastname: Li
authors.affiliation: Department of Critical Care Medicine, Jingzhou Central Hospital, Jingzhou, Hubei, 434020, China.
authors.forename: Lianghai
authors.initials: L
authors.lastname: Li
authors.affiliation: Department of Internal medicine, Renmin Hospital of Wuhan University, Wuhan, Hubei, 430060, China.
authors.forename: Zhiyong
authors.initials: Z
authors.lastname: Liu
authors.affiliation: Department of Critical Care Medicine, Renmin Hospital of Wuhan University, Wuhan, Hubei, 430060, China.
authors.forename: Qingshan
authors.initials: Q
authors.lastname: Zhou
authors.affiliation: Department of Surgery, SUNY Upstate Medical University, Syracuse, NY, 13210, USA.
authors.forename: Guirong
authors.initials: G
authors.lastname: Wang
authors.affiliation: Department of Critical Care Medicine, Shanghai Ruijin Hospital Affiliated with Jiaotong University, Shanghai, China. 18918520002@189.cn.
authors.forename: Dechang
authors.initials: D
authors.lastname: Chen
mesh_terms: D058186:Acute Kidney Injury / Q000097:blood / Q000235:genetics* / Q000628:therapy / Q000652:urine; D000328:Adult; D044466:Asian People / Q000235:genetics; D016022:Case-Control Studies; D002681:China; D005260:Female; D020022:Genetic Predisposition to Disease; D000072596:Hepatitis A Virus Cellular Receptor 1 / Q000378:metabolism; D006801:Humans; D008297:Male; D008875:Middle Aged; D011110:Polymorphism, Genetic; D011379:Prognosis; D037663:Pulmonary Surfactant-Associated Protein D / Q000097:blood / Q000235:genetics*; D017582:Renal Replacement Therapy; D012720:Severity of Illness Index
chemical_list: C491143:HAVCR1 protein, human; D000072596:Hepatitis A Virus Cellular Receptor 1; D037663:Pulmonary Surfactant-Associated Protein D
keywords: Acute kidney injury; Kidney injury molecule-1; Polymorphism; Prognosis; Surfactant protein D; Susceptibility