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Ethnicity-Stratified Analysis of the Association between TNF-? Genetic Polymorphisms and Acute Kidney Injury: A Systematic Review and Meta-Analysis.

ABSTRACT: Background:Several studies have reported conflicting findings regarding the association between tumor necrosis factor-alpha (TNF-?) genetic polymorphisms and acute kidney injury (AKI). Therefore, we performed this meta-analysis to further investigate whether TNF-? variants are related to AKI susceptibility. Methods:A comprehensive search of observational studies on the association of TNF-? polymorphism with AKI susceptibility was conducted in the PubMed, Cochrane, and Embase databases through February 10, 2020. Pooled odds ratios (ORs) and 95% corresponding confidence intervals (95% CIs) were analyzed to evaluate the strength of the relationship. Results:A total of 8 studies involving 6694 patients (2559 cases and 4135 controls) were included. Pooled analysis showed a trend of increased risk between the TNF-? rs1800629 variant and AKI (A vs. G: OR?[95%CI] = 1.33?[0.98-1.81]) among the overall population. Ethnicity-stratified analysis indicated that the TNF-? rs1800629 variant was a risk factor for Asians (OR?[95%CI] = 1.93?[1.59-2.35]) while it is not for Caucasians (OR?[95%CI] = 1.04?[0.91-1.20]). Additionally, we also found that TNF-? rs1799964 polymorphism was observed to have a significant relationship with AKI risk in Asian patients (C vs. T, OR?[95%CI] = 1.26?[1.11-1.43]). Conclusions:The TNF rs1800629 polymorphism exhibited a trend toward AKI susceptibility with ethnic differences. The relationship was found to be significant among the Asian population, but not among those of Caucasian origin. Additionally, the TNF-? rs1799964 polymorphism was also related to a significantly increased risk of AKI in Asians.

SUBMITTER: Chen G

PROVIDER: S-EPMC7556080 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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Ethnicity-Stratified Analysis of the Association between TNF-<i>α</i> Genetic Polymorphisms and Acute Kidney Injury: A Systematic Review and Meta-Analysis.

Chen Guanzhong G Liu Bowen B Li Huanqiang H Mai Ziling Z Zhang Liyao L Li Min M Liu Liwei L Chen Shiqun S Chen Jiyan J Liu Yong Y

BioMed research international 20201005

<h4>Background</h4>Several studies have reported conflicting findings regarding the association between tumor necrosis factor-alpha (TNF-<i>α</i>) genetic polymorphisms and acute kidney injury (AKI). Therefore, we performed this meta-analysis to further investigate whether TNF-<i>α</i> variants are related to AKI susceptibility.<h4>Methods</h4>A comprehensive search of observational studies on the association of TNF-<i>α</i> polymorphism with AKI susceptibility was conducted in the PubMed, Cochr ...[more]

PMID: 33083469

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Project description:BackgroundThe functional acute kidney injury (AKI) diagnostic tests serum creatinine (SCr) and urine output are imprecise and make management challenging. Combining tubular injury biomarkers with functional markers reveal AKI phenotypes that may facilitate personalized care. However, when and in whom to obtain injury biomarkers remains unclear.MethodsThis was a prospective, observational study of patients admitted to a pediatric intensive care unit (PICU). Using the Renal Angina Index (RAI), subjects were screened for the presence (RAI+) or absence (RAI-) of renal angina 12 h post-admission and assigned an AKI phenotype using urinary NGAL (NGAL+: ≥150 ng/ml) and SCr (SCr+: ≥KDIGO Stage 1). Outcomes for each AKI phenotype were assessed and compared by RAI status.ResultsIn all, 200/247 (81%) subjects were RAI+. RAI+ subjects who were NGAL+ had higher risk of Day 3 AKI, renal replacement therapy use, and mortality and fewer ventilator- and PICU-free days, compared to NGAL-, irrespective of Day 0 SCr. Similar findings were not demonstrated in RAI- subjects, though NGAL+/SCr+ was associated with fewer ventilator- and PICU-free days compared to NGAL-/SCr+.ConclusionsNGAL- and SCr-based AKI phenotypes provide improved prognostic information in children with renal angina (RAI+) and/or with SCr elevation. These populations may be appropriate for targeted biomarker testing.ImpactNew consensus recommendations encourage the integration of kidney tubular injury biomarkers such as urinary NGAL with serum creatinine for diagnosis and staging of acute kidney injury; however, no structured testing framework exists guiding when to test and in whom. Urinary NGAL- and serum creatinine-based acute kidney injury phenotypes increase diagnostic precision in critically ill children experiencing renal angina (RAI+) or serum creatinine-defined acute kidney injury. These data provide preliminary evidence for a proposed framework for directed urinary NGAL assessment in the pediatric intensive care unit.

Dataset Information

Ethnicity-Stratified Analysis of the Association between TNF-? Genetic Polymorphisms and Acute Kidney Injury: A Systematic Review and Meta-Analysis.

Publications

Ethnicity-Stratified Analysis of the Association between TNF-<i>α</i> Genetic Polymorphisms and Acute Kidney Injury: A Systematic Review and Meta-Analysis.

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