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2017 ; 12
(5
): e0175292
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Association of gain-of-function EPHX2 polymorphism Lys55Arg with acute kidney
injury following cardiac surgery
#MMPMID28552948
Shuey MM
; Billings FT 4th
; Wei S
; Milne GL
; Nian H
; Yu C
; Brown NJ
PLoS One
2017[]; 12
(5
): e0175292
PMID28552948
show ga
Twenty to thirty percent of patients undergoing cardiac surgery develop acute
kidney injury (AKI). In mice, inhibition of soluble epoxide hydrolase (sEH)
attenuates renal injury following ischemia-reperfusion. We tested the hypothesis
that functional variants of EPHX2, encoding sEH, are associated with AKI after
cardiac surgery. We genotyped patients in two independent cardiac surgery cohorts
for functional EPHX2 polymorphisms, Lys55Arg and Arg287Gln, and determined AKI
using Acute Kidney Injury Network criteria. The 287Gln variant was not associated
with AKI. In the discovery cohort, the gain-of-function 55Arg variant was
associated with an increased incidence of AKI in univariate (p = 0.03) and
multivariable (p = 0.04) analyses. In white patients without chronic kidney
disease (CKD), the 55Arg variant was independently associated with AKI with an OR
of 2.04 (95% CI 0.95-4.42) for 55Arg heterozygotes and 31.53 (1.57-633.19) for
homozygotes (p = 0.02), after controlling for age, sex, body mass index, baseline
estimated glomerular filtration rate, and use of cardiopulmonary bypass. These
findings were replicated in the second cardiac surgery cohort. 12,13- and total-
dihydroxyoctadecanoic acids (DiHOME): epoxyoctadecanoic acids (EpOME) ratios were
increased in EPHX2 55Arg variant carriers, consistent with increased hydrolase
activity. The EPHX2 Lys55Arg polymorphism is associated with AKI following
cardiac surgery in patients without preexisting CKD. Pharmacological strategies
to decrease sEH activity might decrease postoperative AKI.