Expression and clinical significance of serum arginase-2 in cardiac surgery associated acute kidney injury

doi:10.11958/20252825

Abstract

Abstract:

Objective To investigate the expression of serum arginase 2 (Arg-2) in patients with cardiac surgery-related acute kidney injury (CAS-AKI) and its relationship with clinical prognosis. Methods A total of 112 patients who underwent cardiac surgery were selected and divided into the acute kidney injury (AKI) group (35 cases) and the non-AKI group (77 cases) based on whether AKI occurred within 7 days after surgery. The differences in serum Arg-2 levels between the two groups were compared. The correlation between serum Arg-2 levels and renal function indicators was analyzed. The receiver operating characteristic (ROC) curve was used to analyze the auxiliary diagnostic value of serum Arg-2 for CAS-AKI. Logistic regression analysis was used to analyze the influence of Arg-2 on the occurrence of CAS-AKI. Results The serum Arg-2 level was higher in the AKI group than that in the non-AKI group. The expression level of serum Arg-2 was positively correlated with serum creatinine (Scr), neutrophil gelatinase-associated lipocalin (NGAL) and urinary kidney injury molecule-1 (Kim-1). The elevated expression of serum Arg-2 was an independent risk factor for the occurrence of CAS-AKI (OR=1.045，95%CI：1.009-1.082). Serum Arg-2 alone had a high sensitivity and specificity for predicting CAS-AKI, which were 74.30% and 66.20%, respectively. And the area under the curve (AUC) was 0.738 (95%CI: 0.636 - 0.840). Combining with Kim-1 and NGAL could improve the sensitivity and specificity of diagnosing CAS-AKI (85.70% and 81.80%), respectively, with an AUC increase to 0.886 (95%CI: 0.823 - 0.950). Conclusion The expression level of serum Arg-2 in patients with CAS-AKI is elevated, and it can be used as an early auxiliary diagnostic marker for CAS-AKI.

Key words: acute renal injury, cardiac surgical procedures, arginase, early diagnosis

CLC Number:

R654.2，R692

Figures/Tables 5

References 20

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组别		n	年龄/ 岁		性别（男/女）	高血压病		糖尿病		高尿酸血症		Scr/ （μmol/L）		eGFR/[mL/ （min·1.73 m²）]			BUN/ （mmol/L）
非AKI组		77	50.79±12.83		43/34	28（36.4）		23（29.9）		18（23.4）		136.84±14.83		49.89±10.73			9.86±2.74
AKI组		35	56.62±13.21		20/15	13（37.1）		11（31.4）		9（25.7）		143.71±15.62		43.76±11.82			11.63±3.15
t或χ²			2.209^＊		0.016	0.006		0.028		0.072		2.235^＊		2.714^＊＊			3.020^＊＊
组别	血红蛋白/（g/L）			血清白蛋白/ （g/L）			尿酸/ （μmol/L）		乳酸/ （mmol/L）		C反应蛋白/（mg/L）		心脏瓣膜手术		冠脉手术	体外循环时间/h		使用血管活性药物
非AKI组	112.46±16.56			31.28±4.85			485.74±31.74		1.98±0.84		10.57±5.68		37（48.1）		32（41.6）	2.06±1.38		70（90.9）
AKI组	110.62±17.31			30.64±5.23			495.93±32.85		2.15±0.98		11.28±4.26		16（45.7）		13（37.1）	2.94±1.41		31（88.6）
t或χ²	0.537			0.631			1.558		0.933		0.658		0.053		0.195	3.103^＊＊		0.148

组别		n	年龄/ 岁		性别（男/女）	高血压病		糖尿病		高尿酸血症		Scr/ （μmol/L）		eGFR/[mL/ （min·1.73 m²）]			BUN/ （mmol/L）
非AKI组		77	50.79±12.83		43/34	28（36.4）		23（29.9）		18（23.4）		136.84±14.83		49.89±10.73			9.86±2.74
AKI组		35	56.62±13.21		20/15	13（37.1）		11（31.4）		9（25.7）		143.71±15.62		43.76±11.82			11.63±3.15
t或χ²			2.209^＊		0.016	0.006		0.028		0.072		2.235^＊		2.714^＊＊			3.020^＊＊
组别	血红蛋白/（g/L）			血清白蛋白/ （g/L）			尿酸/ （μmol/L）		乳酸/ （mmol/L）		C反应蛋白/（mg/L）		心脏瓣膜手术		冠脉手术	体外循环时间/h		使用血管活性药物
非AKI组	112.46±16.56			31.28±4.85			485.74±31.74		1.98±0.84		10.57±5.68		37（48.1）		32（41.6）	2.06±1.38		70（90.9）
AKI组	110.62±17.31			30.64±5.23			495.93±32.85		2.15±0.98		11.28±4.26		16（45.7）		13（37.1）	2.94±1.41		31（88.6）
t或χ²	0.537			0.631			1.558		0.933		0.658		0.053		0.195	3.103^＊＊		0.148

组别	n	Kim-1/（ng/L）	NGAL/（μg/L）	Arg-2/（U/L）
非AKI组	77	365.48±51.56	294.71±19.85	50.64±18.42
AKI组	35	427.63±52.78	320.27±15.79	67.89±21.37
t		5.870^＊＊	6.709^＊＊	4.366^＊＊

组别	n	Kim-1/（ng/L）	NGAL/（μg/L）	Arg-2/（U/L）
非AKI组	77	365.48±51.56	294.71±19.85	50.64±18.42
AKI组	35	427.63±52.78	320.27±15.79	67.89±21.37
t		5.870^＊＊	6.709^＊＊	4.366^＊＊

因素	β	SE	Wald χ²	P	OR（95%CI）
年龄	0.039	0.027	2.078	0.149	1.040（0.986~1.097）
Scr	0.005	0.020	0.067	0.796	1.005（0.966~1.046）
BUN	0.251	0.123	4.166	0.041	1.285（1.010~1.635）
体外循环时间	0.414	0.234	3.120	0.077	1.513（0.956~2.394）
Arg-2	0.044	0.018	5.997	0.014	1.045（1.009~1.082）
Kim-1	0.020	0.008	6.673	0.010	1.020（1.005~1.035）
NGAL	0.076	0.021	13.517	<0.001	1.078（1.036~1.123）
常数项	-41.012	8.533	23.099	<0.001	0.000