ArticleAmerican journal of physiology. Heart and circulatory physiology2026
Urinary UDP-sugars provide actionable prediction of acute kidney injury in cardiac surgery patients.
Article in American journal of physiology. Heart and circulatory physiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Acute kidney injury (AKI) affects up to 50% of patients undergoing cardiopulmonary bypass, yet early diagnostic biomarkers and targeted therapies remain limited. Although AKI is attributed to bypass-induced renal ischemia, the underlying molecular mechanisms are poorly understood. This study characterizes renal inflammatory dynamics in cardiac surgery patients, beginning intraoperatively. One hundred adults undergoing cardiopulmonary bypass were enrolled at the Quebec Heart and Lung Institute in Canada (July 2021-April 2024). Urine and plasma samples were collected before and up to 5 days post bypass. Proinflammatory P2Y14 receptor ligands (UDP-sugars) were quantified by LC-ESI-MS/MS, and kidney injury marker-1 (KIM-1) and inflammatory mediators were measured by multiplex immunoassays. AKI was defined using modified KDIGO criteria: serum creatinine increase ≥ 0.3 mg/dL or urine output ≤ 0.5 mL/kg/h for 24 h postoperatively. Urinary UDP-sugars increased significantly within 0-4 h post bypass in patients with AKI, whereas plasma levels remained unchanged. Urinary UDP-sugars correlated with KIM-1 at 4 h and preceded proinflammatory cytokines (CXCL1, CCL2, and IL-18), which peaked at 12 h. Immunofluorescence localized P2Y14 to collecting duct apical membranes, and detected CD45
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