COMT-Val158Met-Polymorphism Is Not a Risk Factor for Acute Kidney Injury after Cardiac Surgery

الملخص EN

Background.

Cardiac surgery-associated acute kidney injury (CSA-AKI) depicts a major complication after cardiac surgery using cardiopulmonary bypass (CPB).

Objective.

CSA-AKI has clearly been linked to increased perioperative morbidity and mortality.

Dysregulations of vasomotor tone are assumed to be causal for CSA-AKI.

While catechol-O-methyltransferase (COMT) is involved in metabolizing catecholamines, a single-nucleotide polymorphism (SNP) in the COMT gene leads to different enzyme activities according to genotype.

Pilot studies found associations between those COMT genotypes and CSA-AKI.

Methods.

We prospectively included 1741 patients undergoing elective cardiac surgery using cardiopulmonary bypass (CPB).

Patients were genotyped for COMT-Val158Met-(G/A) polymorphism (rs4680).

Results.

Demographic characteristics and procedural data revealed no significant differences between genotypes.

No association between COMT genotypes and the RIFLE criteria could be detected.

A multiple linear regression analysis for postoperative creatinine increase revealed highly significant associations for aortic cross-clamp time (P<0.001), CPB time (P<0.001), norepinephrine (P<0.001), and age (P<0.001).

No associations were found for COMT genotypes or baseline creatinine.

With an R2=0.39 and a sample size of 1741, the observed power of the regression analysis was >99%.

Conclusions.

Based on our results, we can rule out an association between the COMT-Val158Met-(G/A) polymorphism and the appearance of CSA-AKI.