Study On The Relationship Between Aquaporin 2 And Acute Kidney Injury After Cardiac Cardiopulmonary Bypass Surgery

BACKGROUND: Acute kidney injury(AKI)is one of the most common complications after cardiac surgery.Although renal function can be completely restored to normal,AKI can still affect patient survival for up to ten years.There is growing evidence that Aquaporin(AQP)play an important role in renal drainage.There is no uniform conclusion on the pattern of changes in AQP after extracorporeal circulation.Currently,the commonly used clinical indicators to evaluate kidney function are creatinine and urea,however,because of the strong compensatory capacity of the kidney,it often shows an increase in creatinine only when the kidney damage is more than 50%.Using creatinine to evaluate acute kidney function damage after surgery has a certain lag,which is not conducive to timely management of kidney function after surgery,and creatinine indicators cannot provide information for clinical prognosis,so new test indicators need to be discovered.METHODS: Patients were selected according to certain inclusion and exclusion criteria,all basic preoperative and postoperative data were collected,preoperative and postoperative urine samples were collected,the supernatant was collected after centrifugation,the expression of AQP2 in urine was detected by ELISA and the data were recorded,for the above data,ANOVA and logistics regression analysis were used to screen out and independent risk factors for AKI,and the data were propensity The data were matched by ANOVA and logistic regression analysis to screen out independent risk factors for AKI,and the data were propensity score matching(PSM)to analyze the degree of influence of AQP2 on AKI in patients after excluding gender、age、preoperative renal function and other relevant confounding factors.RESULTS: Preoperative creatinine level,preoperative AQP2,and the amount of intraoperative AQP2 change were independent risk factors for AKI.Patients with poorer preoperative basal renal function had a higher risk of AKI,and patients without AKI had higher AQP2 than preoperative,while patients with AKI had lower AQP2 than preoperative.The amount of intraoperative water channel protein 2 change was related to the duration of extracorporeal circulation,and the longer the duration of extracorporeal circulation,the more obvious the decrease of water channel protein 2compared with the preoperative period,and there was also a linear correlation between the amount of water channel protein 2 change during surgery and the postoperative creatinine change,the more obvious the decrease of water channel protein 2 compared with the preoperative period,the more obvious the increase of creatinine,and the more serious the kidney injury.Patients with lower preoperative AQP2 levels were less likely to develop AKI.CONCLUSION: The preoperative creatinine level,preoperative AQP2,and the amount of intraoperative AQP2 changes are independent risk factors for AKI.