Protein kinase N1 level predicts acute kidney injury in patients undergoing cardiac surgery：A prospective cohort study.

Abstract

The objective of this study is to examine the utility of protein kinase N1 (PKN1) as a biomarker of cardiac surgery-associated AKI (CSA-AKI). A prospective cohort study of 110 adults undergoing on-pump cardiac surgery was conducted. The associations between post-operative PKN1 and CSA-AKI, AKI severity, need for renal replacement therapy (RRT), duration of AKI, length of ICU stay and post-operative hospital stay were evaluated. Patients were categorized into three groups according to PKN1 tertiles. The incidence of CSA-AKI in the third tertile was 3.4-fold higher than that in the first. PKN1 was an independent risk factor for CSA-AKI. The discrimination of PKN1 to CSA-AKI assessed by ROC curve indicated that the AUC was 0.70, and the best cutoff was 5.025ng/mL. This group (>5.025ng/mL) was more likely to develop CSA-AKI (P<0.001). The combined AUC of EuroSCORE, aortic cross-clamp time and PKN1 was 0.82 (P<0.001). A higher level of PKN1 related to increased need for RRT, longer duration of AKI, and length of ICU and post-operative hospital stays. PKN1 could be a potential biomarker for the prediction of CSA-AKI. The combination of PKN1, EuroSCORE and aortic cross-clamp time were likely to predict the occurrence of CSA-AKI.