Elevated Plasma Catalytic Iron May Increase Risk of AKI and Death Following Cardiac Surgery

After adjusting for age and preoperative eGFR, cardiopulmonary bypass patients in the highest quartile of plasma catalytic iron compared with the lowest quartile on postoperative day 1 had a 6.71 greater likelihood of experiencing a composite outcome of AKI requiring renal replacement therapy or in-hospital mortality. They also had an increased likelihood of experiencing AKI, hospital mortality, and postoperative myocardial injury. The Kidney International findings expand on animal studies demonstrating a pathologic role of catalytic iron in affecting postoperative outcomes and suggest interventions aimed at reducing plasma catalytic iron levels may help prevent AKI.

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After adjusting for age and preoperative eGFR, cardiopulmonary bypass patients in the highest quartile of plasma catalytic iron compared with the lowest quartile on postoperative day 1 had a 6.71 greater likelihood of experiencing a composite outcome of AKI requiring renal replacement therapy or in-hospital mortality. They also had an increased likelihood of experiencing AKI, hospital mortality, and postoperative myocardial injury. The Kidney International findings expand on animal studies demonstrating a pathologic role of catalytic iron in affecting postoperative outcomes and suggest interventions aimed at reducing plasma catalytic iron levels may help prevent AKI.

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