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High preoperative serum strontium levels increase the risk of acute kidney injury after cardiopulmonary bypass

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Abstract

Background

Acute kidney injury (AKI) is a common complication of cardiac surgeries. The incidence of AKI after cardiac surgeries using cardiopulmonary bypass (CPB-AKI) is high, emphasizing the need to determine strategies to prevent CPB-AKI. This study investigates the correlation between CPB-AKI and trace metal levels in clinical and animal studies.

Methods

Samples and clinical data were obtained from 74 patients from the Nagoya City University Hospital and Okazaki City Hospital. Blood samples were collected before, immediately after, and 2 h after CPB withdrawal. Trace metal levels were measured using inductively coupled plasma mass spectrometry. Sr or vehicle treatment was orally administered to the rats to determine if Sr was associated with CPB-AKI. After the treatment, ischemia–reperfusion (IR) injury was induced, and serum creatinine (SCr) and blood urea nitrogen (BUN) levels were measured.

Results

In this clinical study, the incidence of CPB-AKI was found to be 28% (21/74). The body mass index and estimated glomerular filtration rate were significantly different in patients with AKI. The intensive care unit and hospital stay were longer in AKI patients than in non-AKI patients. The Na, Fe, and Sr levels were significantly higher in AKI patients before CPB. Also, Fe and Sr were higher immediately after CPB withdrawal, and Sr was higher 2 h after CPB withdrawal in AKI patients. Animal studies showed that Sr-treated rats had significantly increased SCr and BUN levels than vehicle-treated rats at 24 h post-IR injury.

Conclusions

High preoperative serum Sr levels may be associated with CPB-AKI.

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Data Availability

The datasets in the study are available from the corresponding author on reasonable requests.

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Acknowledgements

We would like to thank Editage (www.editage.com) for English language editing. A part of this research has previously been presented at Kidney Week 2020 (American Society of Nephrology).

Funding

Funding acquisition: Yuji Hotta, Akimasa Sanagawa, Tomoya Kataoka, Satoru Takahashi, Kazuya Sobue, Kazunori Kimura. Sources: Yuji Hotta, Akimasa Sanagawa, Tomoya Kataoka, Satoru Takahashi, Kazuya Sobue, Kazunori Kimura. Supervision: Yuji Hotta, Hidekazu Ito, Aya Naiki-Ito, Masahiro Kondo, Tomoya Kataoka, Satoru Takahashi, Kazuya Sobue, Kazunori Kimura.

Author information

Authors and Affiliations

  1. Department of Hospital Pharmacy, Graduate School of Pharmaceutical Sciences, Nagoya City University, 3-1 Tanabe Do-Ri, Mizuho-Ku, Nagoya, 467-8603, Japan

    Natsumi Tomita, Yuji Hotta, Karin Matsuta, Yuko Yamamoto, Akimasa Sanagawa & Kazunori Kimura

  2. Department of Anesthesiology and Intensive Care Medicine, Graduate School of Medical Sciences, Nagoya City University, 1-Kawasumi, Mizuho-Cho, Mizuho-Ku, Nagoya, 467-8601, Japan

    Hidekazu Ito & Kazuya Sobue

  3. Okazaki City Hospital, 3-1, Goshoai, Kouryuji-Cho, Okazaki, 444-8553, Japan

    Hidekazu Ito

  4. Department of Experimental Pathology and Tumor Biology, Graduate School of Medical Sciences, Nagoya City University, 1-Kawasumi, Mizuho-Cho, Mizuho-Ku, Nagoya, 467-8601, Japan

    Aya Naiki-Ito & Satoru Takahashi

  5. Department of Analytical Chemistry, Aichi Prefectural Institute of Public Health, 7-6, Nagare, Tsuji-Machi, Kita-Ku, Nagoya, 462-8576, Japan

    Yuko Yamamoto

  6. Department of Pharmacy, Nagoya City University Hospital, 1-Kawasumi, Mizuho-Cho, Mizuho-Ku, Nagoya, 467-8601, Japan

    Yuji Hotta, Kazuki Ohashi, Tomoaki Hayakawa, Akimasa Sanagawa, Yasuhiro Horita, Masahiro Kondo & Kazunori Kimura

  7. Department of Clinical Pharmaceutics, Graduate School of Medical Sciences, Nagoya City University, 1-Kawasumi, Mizuho-Cho, Mizuho-Ku, Nagoya, 467-8601, Japan

    Yasuhiro Horita, Tomoya Kataoka & Kazunori Kimura

Authors
  1. Natsumi Tomita
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  2. Yuji Hotta
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  3. Hidekazu Ito
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  4. Aya Naiki-Ito
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  5. Karin Matsuta
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  6. Yuko Yamamoto
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  7. Kazuki Ohashi
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  8. Tomoaki Hayakawa
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  9. Akimasa Sanagawa
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  10. Yasuhiro Horita
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  11. Masahiro Kondo
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  13. Satoru Takahashi
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  14. Kazuya Sobue
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  15. Kazunori Kimura
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Contributions

Conceptualization: NT, YH, HI, YH, MK, KK. Methodology: NT, YH, HI, AN-I, KM, YY, KO, TH, AS, YH, MK. Formal analysis and investigation: NT, YH, HI, AN-I, KM, YY, KO, TH, AS, YH, MK. Writing—original draft preparation: NT, YH, HI, AN-I, KM, YY, KO, TH, AS, YH, MK, TK, ST, KS, KK.

Corresponding author

Correspondence to Yuji Hotta.

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Conflict of interest

The authors have declared that no conflict of interest.

Ethical approval

The ethical review board of Nagoya City University Graduate School of Medical Sciences and Okazaki City Hospital approved this cohort study (60-16-0208). Study was conducted with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. All animal procedures were approved by the Ethics Committee of Nagoya City University (H25-P-10) and were performed according to the Guiding Principles for the Care and Use of Laboratory Animals from the Science and International Affairs Bureau of the Japanese Ministry of Education, Culture, Sports, Science and Technology.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Tomita, N., Hotta, Y., Ito, H. et al. High preoperative serum strontium levels increase the risk of acute kidney injury after cardiopulmonary bypass. Clin Exp Nephrol 27, 382–391 (2023). https://doi.org/10.1007/s10157-022-02314-w

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  • DOI: https://doi.org/10.1007/s10157-022-02314-w

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