Genetic and clinical risk factors for fluid overload following open-heart surgery

Autor:	T B, Enger, H, Pleym, R, Stenseth, A, Wahba, V, Videm
Rok vydání:	2014
Předmět:	Adult Male Genotype Water-Electrolyte Imbalance Comorbidity Kidney Polymorphism Single Nucleotide Postoperative Complications Sex Factors Risk Factors Uromodulin Humans Blood Transfusion Genetic Predisposition to Disease Prospective Studies Cardiac Surgical Procedures Intraoperative Complications Alleles Aged Hypolipidemic Agents Contraindications Body Weight Age Factors Middle Aged Fluid Therapy Female Hemofiltration
Zdroj:	Acta anaesthesiologica Scandinavica. 58(5)
ISSN:	1399-6576 2008-2010
Popis:	Post-operative fluid overload following cardiac surgery is associated with increased morbidity and mortality. We hypothesised that genetic variations and pre-operative clinical factors predispose some patients to post-operative fluid overload.Perioperative variables were collected prospectively for 1026 consecutive adults undergoing open-heart surgery at St. Olavs University Hospital, Norway from 2008-2010. Post-operative fluid overload was defined as a post-operative fluid balance/kg ≥ the 90th percentile of the study population. Genotyping was performed for 31 single-nucleotide polymorphisms related to inflammatory/vascular responses or previously associated with complications following open-heart surgery. Data were analysed using logistic regression modelling, and the findings were internally validated by bootstrapping (n = 100).Homozygous carriers of the common G allele of rs12917707 in the UMOD gene had a 2.2 times greater risk of post-operative fluid overload (P = 0.005) after adjustment for significant clinical variables (age, duration of cardiopulmonary bypass, and intraoperative red cell transfusion). A genetic risk score including 14 single-nucleotide polymorphisms was independently associated with post-operative fluid overload (P = 0.001). The number of risk alleles was linearly associated with the frequency of fluid overload (odds ratio per risk allele 1.153, 95 % confidence interval 1.056-1.258). Nagelkerke's R(2) increased with 7.5% to a total of 25% for the combined clinical and genetic model. Hemofiltration did not reduce the risk.A common variation in the UMOD gene previously shown to be related to renal function was associated with increased risk of post-operative fluid overload following cardiac surgery. Our findings support a genetic susceptibility to disturbed fluid handling following cardiac surgery.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=pmid________::b7b0544410cd014d458c828ef83c5fea https://pubmed.ncbi.nlm.nih.gov/24628133 Zobrazit plný text záznamu Plný text ve formátu PDF Plný text ve formátu HTML
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