Plasma indole-3-aldehyde as a novel biomarker of acute kidney injury after cardiac surgery: a reanalysis using prospective metabolomic data

Hu, Linhui1,2; Bai, Yunpeng2; Lai, Changchun3; Mo, Leitong4; Li, Ying5; Jiang, Xinyi5,6; Xu, Wang5,7; He, Yuemei2; Zhou, Xinjuan2; Chen, Chunbo8,9

2023-11-07

10.1186/s12871-023-02330-7

BMC ANESTHESIOLOGY   影响因子和分区

1471-2253

BackgroundAcute kidney injury (AKI) is a frequent complication of cardiac surgery that poses significant risks for both the development of chronic kidney diseases and mortality. Our previous study illustrated that heightened expression levels of faecal and plasma indole metabolites before the operation were associated with ischemic AKI. In this study, we aimed to validate the supposition that plasma indole-3-aldehyde (I3A) could serve as a predictive biomarker for AKI in patients undergoing cardiac surgery.MethodsThis statistical reanalysis utilized AKI metabolomic data from patients scheduled for cardiac surgery between April 2022 and July 2022 in two tertiary hospitals. Faecal and blood samples were prospectively collected before surgery within 24 h, and variables related to the preoperative, intraoperative, and postoperative periods were recorded. AKI diagnosis was based on the Kidney Disease Improving Global Outcomes criteria.ResultsIn this study, 55 patients who underwent cardiac surgery were analyzed, and 27 of them (49.1%) developed postoperative AKI. Before surgery, these patients had significantly higher levels of faecal indole metabolites, including skatole, trans-3-indoleacrylic acid, and 5-methoxyindoleacetic acid. The plasma I3A, clinical model that considered perioperative and intraoperative variables, and their combination had area under the receiver operating characteristic curve (ROC) values of 0.79 (95% CI 0.67-0.91), 0.78 (95% CI 0.66-0.90), and 0.84 (95% CI 0.74-0.94) for predicting AKI, respectively. Furthermore, by utilizing net reclassification improvement and integrated discrimination improvement, plasma I3A showed significant improvements in risk reclassification compared to the clinical model alone.ConclusionsThe dysregulation of gut microbiota metabolism in patients scheduled for cardiac surgery can result in an increase in indoles from tryptophan metabolism, which may be associated with postoperative acute kidney injury (AKI). This suggests that indoles may serve as a predictive biomarker for AKI in patients undergoing cardiac surgery.

Indole-3-aldehyde Biomarker Predictor Acute kidney injury Cardiac surgery

SCI

英语

通讯

Anesthesiology

Anesthesiology

WOS:001100798300001

BMC

Web of Science

1.Maoming Peoples Hosp, Dept Crit Care Med, 101 Weimin Rd, Maoming 525000, Guangdong, Peoples R China
2.Maoming Peoples Hosp, Ctr Sci Res, 101 Weimin Rd, Maoming 525000, Guangdong, Peoples R China
3.Maoming Peoples Hosp, Dept Clin Lab, 101 Weimin Rd, Maoming 525000, Guangdong, Peoples R China
4.Maoming Peoples Hosp, Dept Coronary Care Unit, 101 Weimin Rd, Maoming 525000, Guangdong, Peoples R China
5.Guangdong Acad Med Sci, Guangdong Prov Peoples Hosp, Guangdong Cardiovasc Inst, Dept Intens Care,Unit Cardiovasc Surg, 106 Zhongshan Er Rd, Guangzhou 510080, Guangdong, Peoples R China
6.South China Univ Technol, Sch Med, 382 Waihuan East Rd, Guangzhou 510006, Guangdong, Peoples R China
7.Southern Med Univ, Sch Clin Med 2, 1023 Shatai South Rd, Guangzhou 510515, Guangdong, Peoples R China
8.Jinan Univ, Shenzhen Peoples Hosp, The Clin Med Coll 2, Dept Crit Care Med, Shenzhen 518020, Guangdong, Peoples R China
9.Southern Univ Sci & Technol, Affiliated Hosp 1, Shenzhen 518020, Guangdong, Peoples R China

Hu, Linhui,Bai, Yunpeng,Lai, Changchun,et al. Plasma indole-3-aldehyde as a novel biomarker of acute kidney injury after cardiac surgery: a reanalysis using prospective metabolomic data[J]. BMC ANESTHESIOLOGY,2023,23(1).

Hu, Linhui.,Bai, Yunpeng.,Lai, Changchun.,Mo, Leitong.,Li, Ying.,...&Chen, Chunbo.(2023).Plasma indole-3-aldehyde as a novel biomarker of acute kidney injury after cardiac surgery: a reanalysis using prospective metabolomic data.BMC ANESTHESIOLOGY,23(1).

Hu, Linhui,et al."Plasma indole-3-aldehyde as a novel biomarker of acute kidney injury after cardiac surgery: a reanalysis using prospective metabolomic data".BMC ANESTHESIOLOGY 23.1(2023).