Perioperative high density lipoproteins, oxidative stress, and kidney injury after cardiac surgery

Loren E. Smith; Derek K. Smith; Patricia G. Yancey; Valentina Kon; Alan T. Remaley; Frederic T. Billings; MacRae F. Linton

doi:10.1016/j.jlr.2021.100024

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Perioperative high density lipoproteins, oxidative stress, and kidney injury after cardiac surgery

Journal article

Open access

Peer reviewed

Perioperative high density lipoproteins, oxidative stress, and kidney injury after cardiac surgery

Loren E. Smith, Derek K. Smith, Patricia G. Yancey, Valentina Kon, Alan T. Remaley, Frederic T. Billings and MacRae F. Linton

Journal of lipid research, Vol.62, p.100024

01/01/2021

DOI: 10.1016/j.jlr.2021.100024

PMCID: PMC7905072

PMID: 33453220

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https://doi.org/10.1016/j.jlr.2021.100024View

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Abstract

Oxidative stress promotes acute kidney injury (AKI). Higher HDL cholesterol concentrations are associated with less AKI. To test the hypothesis that HDL antioxidant activity is associated with AKI after cardiac surgery, we quantified HDL particle (HDL-P) size and number, paraoxonase-1 (PON-1) activity, and isofuran concentrations in 75 patients who developed AKI and 75 matched control patients. Higher preoperative HDL-P was associated with less AKI (OR: 0.80; 95% CI, 0.71–0.91; P = 0.001), higher PON-1 activity ( P < 0.001), and lower plasma concentrations of isofurans immediately after surgery (P = 0.02). Similarly, higher preoperative small HDL-P was associated with less AKI, higher PON-1 activity, and lower isofuran concentrations. Higher intraoperative particle losses were associated with less AKI (OR: 0.79; 95% CI 0.67–0.93; P = 0.005), and with decreased postoperative isofuran concentrations (P = 0.04) . Additionally, higher preoperative small HDL-P and increased intraoperative small particle loss were associated with improved long-term renal function (P = 0.003, 0.01, respectively). In conclusion, a higher preoperative concentration of HDL-P, particularly small particles, is associated with lower oxidative damage and less AKI. Perioperative changes in HDL-P concentrations are also associated with AKI. Small HDL-P may represent a novel modifiable risk factor for AKI.

cardiovascular disease

cholesterol

eicosanoids

HDL function

paraoxonase

renal disease

Details

Title: Subtitle: Perioperative high density lipoproteins, oxidative stress, and kidney injury after cardiac surgery
Creators: Loren E. Smith - Vanderbilt University Medical Center
Derek K. Smith - Vanderbilt University Medical Center
Patricia G. Yancey - Vanderbilt University Medical Center
Valentina Kon - Vanderbilt University Medical Center
Alan T. Remaley - National Heart Lung and Blood Institute
Frederic T. Billings - Vanderbilt University Medical Center
MacRae F. Linton - Vanderbilt University Medical Center
Resource Type: Journal article
Publication Details: Journal of lipid research, Vol.62, p.100024
DOI: 10.1016/j.jlr.2021.100024
PMID: 33453220
PMCID: PMC7905072
NLM abbreviation: J Lipid Res
ISSN: 0022-2275
eISSN: 1539-7262
Publisher: Elsevier Inc
Language: English
Date published: 01/01/2021
Academic Unit: Preventive and Community Dentistry; Anesthesia; Dental Research
Record Identifier: 9984949239802771

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