IMR Press / RCM / Volume 23 / Issue 5 / DOI: 10.31083/j.rcm2305170
Open Access Original Research
Selenoprotein P-1 (SEPP1) as An Early Biomarker of Acute Kidney Injury in Patients Undergoing Cardiopulmonary Bypass
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1 Nephrology and Dialysis Unit, Magna Graecia University, 88100 Catanzaro, Italy
2 Cardiac Surgery Unit, Magna Graecia University, 88100 Catanzaro, Italy
3 Institute of Clinical Physiology, National Research Council (CNR), 89124 Reggio Calabria, Italy
*Correspondence: (Giuseppe Coppolino)
Academic Editor: Brian Tomlinson
Rev. Cardiovasc. Med. 2022, 23(5), 170;
Submitted: 2 March 2022 | Revised: 22 March 2022 | Accepted: 23 March 2022 | Published: 11 May 2022
Copyright: © 2022 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license.

Background: Acute Kidney Injury (AKI) is a frequent, dangerous complication in patients undergoing cardiopulmonary bypass (CPB) with oxidative stress playing a crucial role. In this pilot study we evaluated the possible role of the selenoprotein-p1 (SEPP1), a circulating, anti-oxidant selenium transporter, as a predictive biomarker of AKI in this population setting. Methods: Circulating SEPP1 was measured in the blood of 45 patients before surgery and at 4 h, 8 h and 12 h after CPB by Enzyme-Linked Immunosorbent Assay (ELISA). Results: SEPP1 increased from 69 [IQR 39–85] to 3263 [IQR 1886.2–5042.7] ng/mL (p for trend <0.0001). AKI occurred in 26.7% of patients. In these individuals, an earlier and more prominent increase in SEPP1 was observed at 4 h and 8 h, as compared with those not experiencing AKI (difference between trends p < 0.0001). Logistic regression analyses evidenced 4 h and 8 h SEPP1 as significantly associated with AKI (OR 1.035; 95% CI 1.002–1.068; p = 0.03 and 1.011; 95% CI 1.002–1.021; p = 0.02, respectively). ROC analyses displayed a remarkable discriminatory capacity of early SEPP1 measurements in identifying AKI (AUCs ranging from 0.682 to 0.854; p from 0.04 to <0.0001). In addition, 12 h-SEPP1 showed diagnostic capacity to identify patients reaching a secondary composite endpoint including major adverse kidney events (MAKEs). Conclusions: Findings from this pilot, exploratory study suggest that early SEPP1 measurement after CPB may hold great potential for improving renal risk stratification in cardiac surgery patients. Further studies in wider and more heterogeneous cohorts are needed to generalize these findings and to evaluate a possible applicability in daily practice.

acute kidney injury
cardiopulmonary bypass
Fig. 1.
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