A prospective cohort on prognostic factors for acute kidney injury

2023 Fiscal Year Final Research Report

• Project/Area Number: 20K17253
• Research Category: Grant-in-Aid for Early-Career Scientists
• Allocation Type: Multi-year Fund
• Review Section: Basic Section 53040:Nephrology-related
• Research Institution: Nagoya City University
• Principal Investigator: Miho Murashima 名古屋市立大学, 医薬学総合研究院(医学), 助教 (40771837)
• Project Period (FY): 2020-04-01 – 2024-03-31
• Keywords: 急性腎障害 / 心臓血管外科手術

Outline of Final Research Achievements

Our preliminary analyses showed that eGFR and hemoglobin levels were lower among those who developed acute kidney injury (AKI)over one year after cardiac surgeries. On the other hand, erythropoietin levels were higher among those with AKI (p for interaction 0.08). Also iron sequestration index defined by ln(ferritin/traneferrin saturation) (a marker of chronic inflammation) was higher among those with AKI. These results suggest that the potential for erythropoitein production was preserved even after AKI but anemia might develop due to chronic inflammation and iron sequestation. Total kidney volume was associated with AKI, independent of eGFR. RAS inhibitors use was associated with higher incidence of AKI among those with smaller kidney volume.

Free Research Field

急性腎障害

Academic Significance and Societal Importance of the Research Achievements

AKI後の慢性炎症の遷延が貧血や予後の悪化につながっていることを示唆する結果であった。このことは、AKIの予後を改善するために、慢性炎症の病態を解明し、介入することが必要であることを示唆しており、今後の研究につながるものであった。また、腎容積とAKIの関連が示され、腎容積の大小によりRAS阻害剤のAKIに及ぼす影響が異なることを示した。腎容積は非侵襲的に測定できる値であり、腎容積がAKIのハイリスク群の同定や周術期マネジメントに応用できる可能性がある。