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Acute kidney injury after cardiac surgery is associated with platelet activation
,
Nathan Tyson,
Bryony Eagle–Hemming,
Florence Y. Lai,
Sophia Sheikh,
Kristina Tomkova,
Lathishia Joel–David,
Tracy Kumar,
Hardeep Aujla,
Alison H. Goodall,
Gavin J. Murphy,
Marcin J. Woźniak
Journal of Thrombosis and Haemostasis, Volume: 23, Issue: 9, Pages: 2776 - 2789
Swansea University Author:
Nikol Sullo
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DOI (Published version): 10.1016/j.jtha.2025.06.009
Abstract
Background: Postcardiac surgery acute kidney injury (AKI) is common and associated with high mortality and morbidity. Its pathogenesis remains unclear.Objectives: To determine if platelet activation, extracellular vesicles (EVs), and microRNA levels are associated with postoperative AKI.Methods: Pla...
| Published in: | Journal of Thrombosis and Haemostasis |
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| ISSN: | 1538-7836 1538-7836 |
| Published: |
Elsevier BV
2025
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| Online Access: |
Check full text
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| URI: | https://cronfa.swan.ac.uk/Record/cronfa70469 |
| Abstract: |
Background: Postcardiac surgery acute kidney injury (AKI) is common and associated with high mortality and morbidity. Its pathogenesis remains unclear.Objectives: To determine if platelet activation, extracellular vesicles (EVs), and microRNA levels are associated with postoperative AKI.Methods: Plasma samples from 95 microRNA in Post CArdiac Surgery study patients were collected before, immediately after, and 6 to 12, 24, and 48 hours after surgery. Platelet responsiveness was assessed using a Multiplate aggregometer. Flow cytometry was used to measure platelet and leukocyte activation and for EV derivation. EV size and concentration were analyzed using NanoSight. Circulating biomarkers were measured using immunoassays, and microRNA was analyzed using TaqMan arrays and validated by quantitative real-time polymerase chain reaction.Results: AKI occurred in 57% of patients. Platelet-derived EVs increased 24 hours after surgery in AKI patients. Platelets were desensitized to adenosine diphosphate at 6 to 12 hours, independent of aspirin or P2Y12 antagonist use. AKI patients had more activated platelets at 6 to 12 hours, more platelet-granulocyte aggregates before and at 6 to 12 and 24 hours after surgery, and higher soluble ICAM1 levels before and 48 hours after surgery. TaqMan arrays showed miR-668 was downregulated before and miR-92a-1, -920, -518a-3p, -133b, and -1262 were upregulated after surgery in AKI patients. Quantitative real-time polymerase chain reaction confirmed miR-1262 upregulation. Multivariate analysis showed that granulocyte-platelet aggregates were independently associated with AKI before and at 6 to 12 and 24 hours after surgery. Activated glycoprotein IIb/IIIa and adenosine diphosphate were associated with AKI at 6 to 12 and 24 hours and soluble ICAM1 at 48 hours.Conclusions: AKI is associated with platelet activation, suggesting alternative platelet inhibition may offer renoprotection. Larger studies are needed to validate these findings. |
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| Keywords: |
acute kidney injury, cell-derived microparticles, microRNAs, surgical procedure, blood platelets |
| College: |
Faculty of Medicine, Health and Life Sciences |
| Issue: |
9 |
| Start Page: |
2776 |
| End Page: |
2789 |