Monocyte to high density lipoprotein ratio in patients with acute kidney injury after cardiac surgery

Abstract

Background:

The Monocyte to high density lipoprotein ratio (MHR) has been postulated as a novel parameter associated with adverse renal and cardiovascular outcomes. In this study we investigated the association of MHR with cardiac surgery-associated acute kidney injury (CSA-AKI).

Methods:

In this retrospective study, we analyzed the data pertaining to 1505 patients undergoing cardiopulmonary bypass (CPB) surgery. The CSA-AKI, which was defined using Kidney Disease Improving Global Outcomes criteria. Concurrently, a retrospective scan of patient files was conducted and information relevant to nephropathy such as the level of their serum creatinine (SCr), Blood urea nitrogen (BUN), uric acid (UA), serum cystatin C (Cys-C), total cholesterol (TC), triglycerides (TG), glucose and MHR, ejection fraction, CPB duration time, and other indicators.

Results:

About 1505 patients were studied of whom 195 developed AKI. MHR was significantly higher in the AKI patients (p = 0.001). In multivariate logistic regression analysis, MHR, UA, Cys-C, age, glucose, and history of chronic kidney disease or hypertension were independently correlated with CSA-AKI.

Conclusions:

As a laboratory index, the elevated MHR is convenient, independent, and a useful predictor for CSA-AKI.

Keywords

acute kidney injury cardiac surgery cardiopulmonary bypass monocyte to high density lipoprotein ratio

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References

Wang

Bellomo

. Cardiac surgery-associated acute kidney injury: risk factors, pathophysiology and treatment. Nat Rev Nephrol 2017; 13: 697–711.

Chen

Yang

. Biomarkers of acute kidney injury after cardiac surgery: a narrative review. Biomed Res Int 2019; 2019: 7298635.

Olowu

Niang

Osafo

, et al. Outcomes of acute kidney injury in children and adults in sub-Saharan Africa: a systematic review. Lancet Global Health 2016; 4: e242–e250.

Guan

, et al. Risk factors of cardiac surgery-associated acute kidney injury: development and validation of a perioperative predictive nomogram. J Nephrol 2019; 32: 937–945.

Weedle

Da Costa

Veerasingam

, et al. The use of neutrophil lymphocyte ratio to predict complications post cardiac surgery. Ann Transl Med 2019; 7: 778.

Yılmaz

Kayançiçek

. A new inflammatory marker: elevated monocyte to HDL cholesterol ratio associated with smoking. J Clin Med 2018; 10: 7.

Kanbay

Solak

Unal

, et al. Monocyte count/high density lipoprotein cholesterol ratio and cardiovascular events in patients with chronic kidney disease. Int Urol Nephrol 2014; 46: 1619–1625.

Karatas

Canga

Ozcan

, et al. Monocyte to high-density lipoprotein ratio as a new prognostic marker in patients with STEMI undergoing primary percutaneous coronary intervention. Am J Emerg Med 2016; 34: 240–244.

Bolayir

Gokce

Cigdem

, et al. Monocyte/high-density lipoprotein ratio predicts the mortality in ischemic stroke patients. Neurol Neurochir Pol 2018; 52: 150–155.

10.

Koseoglu

Pazarli

Kanbay

, et al. Monocyte count/high density lipoprotein cholesterol ratio and cardiovascular disease in patients with obstructive sleep apnea syndrome: a multicenter study. Clin Appl Thromb Hemost 2018; 24: 139–144.

11.

Canpolat

Çetin

Cetin

, et al. Association of monocyte-to-high density lipoprotein cholesterol ratio with slow coronary flow is linked to systemic inflammation. Clin Appl Thromb Hemost 2016; 22: 476–482.

12.

Ostermann

Bellomo

Burdmann

, et al. Controversies in acute kidney injury: conclusions from a kidney disease: improving global outcome conference. Kidney Int 2020; 98: 294–309.

13.

Cho

Shim

Lee

, et al. Chronic progression of cardiac surgery associated acute kidney injury: intermediary role of acute kidney disease. J Thorac Cardiovasc Surg 2021; 161: 681–683.

14.

Wan

Xie

Gendoo

, et al. Ulinastatin administration is associated with a lower incidence of acute kidney injury after cardiac surgery: a propensity score matched study. Crit Care 2016; 20: 42.

15.

Chen

, et al. Novel potential biomarker of adult cardiac surgery-associated acute kidney injury. Front Physiol 2020; 11: 587204.

16.

Woollard

Geissmann

. Monocytes in atherosclerosis: subsets and functions. Nat Rev Cardiol 2010; 7: 77–86.

17.

Mestas

Ley

. Monocyte-endothelial cell interactions in the development of atherosclerosis. Trends Cardiovasc Med 2008; 18: 228–232.

18.

Gordon

Chung

Playford

, et al. High density lipoprotein proteome is associated with cardiovascular risk factors and atherosclerosis burden as evaluated by coronary CT angiography Atherosclerosis 2018; 278: 278–285.

19.

Aydin

Ates

Fettah Arikan

, et al. The ratio of monocyte frequency to HDL cholesterol level as a predictor of asymptomatic organ damage in patients with primary hypertension. Hypertens Res 2017; 40: 758–764.