Research On The Relevance Of MicroRNA-214/-218 And Acute Renal Injury In Children Undergoing Cardiac Surgery With Cardiopulmonary Bypass

ObjectiveTo explore the levels of microRNA-214/-218 in blood and urine in children undergoing congenital cardiac surgery with cardiopulmonary bypass(CPB), and to investigate the relationship between microRNA-214/-218 and acute kidney injury, to explore the effect of remote ischemic preconditioning on the expression of miR-214/-218.MethodsChildren who were hospitalized between December 2013 and June 2015 in department of cardiothoracic surgery of Hunan Children's hospital, diagnosed as congenital heart disease, scheduled for cardiac surgery with CPB were eligible for enrollment. They were randomly divided into control group and intervention group, and the intervention group were performed remote ischemic preconditioning 12 hours before CPB. Detect the serum creatinine level, MiR-214/-218 expression in blood and urine before and after CPB. Real-time quantitative PCR detect the microRNA-214/-218 in blood and urine.Result(1)A total of 449 children were enrolled in the study, there are 263 males and 228 females, and their median age was(33.11+26.83)months.The control group has 270 patients and other 221 patients are in intervention group.There were no significant differents in sex, age,operation complexity,operation type, operation time, parallel circulation time, aortic clamping time, time of transfer, number of times of intraoperative hypotension, time of ventilator use and intensive care timecomposition between the two group( P > 0.05).(2) The serum creatinine level in the intervention group was significantly lower than that in the control group at 24 h and 48 h after CPB(P<0.01).(3)To the AKI children in control group who scheduled for cardiac surgery with CPB,the levels of miR-214/-218 in blood were gradually increased, and the peak values were 7.39 and 9.52 times of Baseline level after 48h; the levels of mi R-214/-218 in urine were increased,and the peak values were4.65 and 6.08 times of Baseline level after 72 h.(4)To the AKI children in intervention group who scheduled for cardiac surgery with CPB, the levels of miR-214/-218 in blood were gradually increased,and the peak values were 4.08 and 6.91 times of baseline level after 48h; the levels of miR-214/-218 in urine were increased,and the peak values were3.85 and4.52 times of Baseline level after 72 h. The level of miR-214/-218 in blood and urine in intervention group was lower than that in controlgroup after CPB.(5) There were no significant differences in levels of miR-214/-218 in the blood and urine of non-AKI patients in the control group and the intervention group.Conclusions(1)Mi R-214/-218 can stable express in blood and urine after CPB in children with congenital cardiac surgery.(2) The expression level of miR-214/-218 in blood and urine was increased in AKI children with congenital cardiac surgery CPB.(3)Remote ischemic preconditioning can decrease the expression of miR-214/-218 in blood and urine in children with congenital cardiac surgery CPB.(4) The increased expression of miR-214/-218 may do harm to the kidney.