Protein Kinase N1 Level Predicts Acute Kidney Injury in Patients Undergoing Cardiac Surgery: A Prospective Cohort Study

Blood Purif. 2024;53(6):465-475. doi: 10.1159/000536225. Epub 2024 Jan 16.

Abstract

Introduction: The objective of this study was to examine the utility of protein kinase N1 (PKN1) as a biomarker of cardiac surgery-associated AKI (CSA-AKI).

Methods: A prospective cohort study of 110 adults undergoing on-pump cardiac surgery was conducted. The associations between post-operative PKN1 and CSA-AKI, AKI severity, need for renal replacement therapy (RRT), duration of AKI, length of ICU stay, and post-operative hospital stay were evaluated.

Results: Patients were categorized into three groups according to PKN1 tertiles. The incidence of CSA-AKI in the third tertile was 3.4-fold higher than that in the first. PKN1 was an independent risk factor for CSA-AKI. The discrimination of PKN1 to CSA-AKI assessed by ROC curve indicated that the AUC was 0.70, and the best cutoff was 5.025 ng/mL. This group (>5.025 ng/mL) was more likely to develop CSA-AKI (p < 0.001). The combined AUC of EuroSCORE, aortic cross-clamp time, and PKN1 was 0.82 (p < 0.001). A higher level of PKN1 was related to increased need for RRT, longer duration of AKI, and length of ICU and post-operative hospital stays.

Conclusions: PKN1 could be a potential biomarker for the prediction of CSA-AKI. The combination of PKN1, EuroSCORE, and aortic cross-clamp time was likely to predict the occurrence of CSA-AKI.

Keywords: Biomarker; Cardiac surgery-associated acute kidney injury; Cardiopulmonary bypass; Prediction; Protein kinase N1.

Publication types

  • Evaluation Study

MeSH terms

  • Acute Kidney Injury* / blood
  • Acute Kidney Injury* / diagnosis
  • Acute Kidney Injury* / epidemiology
  • Acute Kidney Injury* / etiology
  • Aged
  • Area Under Curve
  • Biomarkers / blood
  • Cardiac Surgical Procedures* / adverse effects
  • Female
  • Humans
  • Intensive Care Units / statistics & numerical data
  • Length of Stay / statistics & numerical data
  • Male
  • Middle Aged
  • Postoperative Complications / diagnosis
  • Postoperative Complications / epidemiology
  • Postoperative Complications / etiology
  • Prospective Studies
  • Protein Kinase C* / blood
  • Renal Replacement Therapy / statistics & numerical data
  • Risk Assessment / methods
  • Severity of Illness Index

Substances

  • protein kinase N
  • Protein Kinase C
  • Biomarkers