174 32nd World Congress of Internal Medicine (October 24-28, 2014) WCIM 2014
PS 0494 Nephrology
Effects of Acute Kidney Injury and Chronic Kidney Disease on Long-Term Mortality After Coronary Artery Bypass Grafting
Seung Seok HAN1, Nara SHIN1, Seon Ha BAEK1, Shin Young AHN1, Dong Ki KIM1, Sejoong KIM1, Ho Jun CHIN1, Dong-Wan CHAE1, Ki Young NA1
Seoul National University College of Medicine, Korea1
Background: Both acute kidney injury (AKI) and chronic kidney disease (CKD) are im- portant issues in patients undergoing coronary artery bypass grafting (CABG), particu- larly with regard to mortality. However, their synergistic or discrete effects on long- term mortality remain unresolved.
Methods: A total of 1899 patients undergoing CABG were retrospectively analyzed.
The adjusted hazard ratios (HRs) for all-cause mortality were calculated after strat- ifying the timeframes. To evaluate the synergistic effects between AKI and CKD, the relative excess risk due to interaction (RERI) was applied.
Results: The presence of AKI, CKD, or both increased the HRs for mortality, compared with the absence of both: AKI alone, 1.84 (1.464–2.319); CKD alone, 2.46 (1.735–3.478);
and AKI and CKD together, 3.21 (2.301–4.488) [Figure 1]. However, the relationships with mortality were different between AKI and CKD, according to the timeframes:
AKI primarily affected early mortality, particularly within 3 years, whereas CKD had a relatively constant effect on both the early and the late periods. When the parameters from the RERI were obtained, there was a synergistic effect on early mortality be- tween AKI and CKD.
Conclusions: The relationships with mortality following CABG were different between AKI and CKD. However, their effects were not exclusive but synergistic.
PS 0495 Nephrology
Transgenic Mice with High Endogeous Omega-3 Fatty Acid are Protected from Ischemia Reperfusion Induced Acute Kidney Injury
Won Min HWANG1, Se Hee YOON1, Dong Mee LIM2, Kwang Sik YOO3, Seung-Yun HAN3, Jaeku KANG4, Sungro YUN1
Department of Nephrology, College of Medicine, Konyang University, Korea1, Department of Endocri- nology, College of Medicine, Konyang University, Korea2, Department of Anatomy, College of Medicine, Konyang University, Korea3, Department of Pharmacology, College of Medicine, Konyang University, Korea4
Background: Acute kidney injury (AKI) is common clinical event and has high mortal- ity rate despite advanced curative strategies. Several studies found that omega-3 pol- yunsaturated fatty acid (PUFA) diet reduces kidney dysfunction followed by ischemic injury. However oral appliance of omega-3 PUFA, in fact, can cause much variability arisen from diet procedure. Fat-1 transgenic mouse produce abundant omega-3 PUFA, result in balanced omega-6: omega-3 ratio than wild type mouse. The purpose of this study, therefore, is to see whether omega-3 PUFA has advantages in AKI caused by ischemic injury using fat-1 transgenic mice.
Methods: Bilateral kidneys were subjected to 30 minutes of ischemia by clipping of both renal arteries, renal ischemia-reperfusion injury (IRI) was performed. Animals (fat-1 mice and C57BL/6 mice) are sacrificed 24 and 72 h of reperfusion. The effects of omega-3 PUFA on renal IRI were evaluated in terms of renal function, tubular necrosis, infl ammatory cell infi ltration. After that, renal function and severities of renal injury were estimated.
Results: Fat-1 mice could reduce to increased BUN, serum creatinine and tissue Kim-1 levels(Figure), and reduce neutrophil infi ltration in body after IRI, compared with Wild Type mice.
Conclusions: Long-term and high dose of omega-3 supplement can protect renal function and facilitate renal recovery following IRI.
