Abstract 17511: Microvesicles and MicroRNAs as Marker of Acute Kidney Injury After Cardiac Surgery in Children
Introduction: AKI is very common in paediatric cardiac surgery patients. The diagnosis relies on changes in serum creatinine and urine output, which lack specificity and sensitivity especially in newborns and premature infants. Diagnostic changes also occur late in the injury phase when interventions have limited effectiveness. Microvesicles (MV) are small particles (<1μm) in plasma that often contain miRNA. Their levels have been shown to be altered in animal models of AKI where they regulate injury responses.
Hypothesis: MV and associated miRNA provide specific and early-detection markers for AKI and a tool to investigate AKI pathogenesis.
Methods: Study subjects were 24 children (<17 yrs), undergoing cardiac surgery with cardiopulmonary bypass (CPB) without pre-existing inflammatory state, AKI or extracorporeal life support. AKI was diagnosed following the KDIGO definition. Blood and urine samples were collected pre-operatively and at 6 and 24 hours. Cytokines were measured on a MAGPIX platform. Leukocyte and platelets activation, and MV derivation was assessed by flow cytometry and NanoSight device. miRNAs were isolated from MV preps and analyzed by RT-PCR using Applied Biosystems kits.
Results: AKI was diagnosed in 14 patients and was confirmed by urinary NGAL increase at 6 hours after the operation (25±3.45 ng/ml vs 10.44±2.9 ng/ml; p 0.006). Patients with AKI were younger, underwent longer CPB, received higher volumes of red blood cells, and required higher inotrope support (Table). AKI subjects had increased levels of monocyte and B1-integrin MV. That correlated well with IL-8 and MCP-3 levels and monocyte activation. These changes were also reflected in miRNA profile in both groups.
Conclusions: MV and miRNA could potentially serve as early AKI markers in children and their analysis reveals mechanistic parallels with adults.
Author Disclosures: S. Mariani: None. N. Sullo: None. M. Jn Tala: None. W. Dott: None. M.J. Wozniak: None. D. Chan: None. T. Kumar: None. A.A. Lotto: None. G.J. Murphy: None.
- © 2015 by American Heart Association, Inc.