Telomere biology and acute kidney injury in cardiac surgery
Research type
Research Study
Full title
Telomere length and telomerase activity as a predictor of acute kidney injury following cardiac surgery
IRAS ID
181330
Contact name
Magdi Yaqoob
Contact email
Sponsor organisation
Queen Mary University of London
Duration of Study in the UK
3 years, 0 months, 1 days
Research summary
Patients with underlying kidney disease undergoing cardiopulmonary bypass are at an increased risk of developing acute kidney injury (AKI) in the post-operative period. In addition, a proportion of patients with normal kidney function also develop AKI following cardiac surgery. Studies show that this patient population have a poorer long term prognosis, even if their kidney function subsequently returns to normal. However, the cause for this is not currently understood.
Telomeres are nucleotide sequences that cap the ends of chromosomes. They are progressively shortened during cell division until further division is inhibited. This rate of shortening is modulated by the enzyme telomerase. When the telomere length is reduced to a point where further cell division is prohibited, the cell becomes senescent or undergoes apoptosis. Hence patients with reduced telomere length (TL) and telomerase activity (TA) have a reduced reserve for further cellular division and reduced ability to regenerate following injury.
We postulate that this lack of cell reserve and regeneration might explain why certain patients appear to be predisposed to developing AKI following cardiac surgery, and why they subsequently have a poorer long term prognosis, even if they fully recover from their renal injury. Identification of such a link might allow better pre-operative risk stratification tools than those currently in use.
This is an observational prospective cohort study in all patients undergoing cardiac surgery. It will involve taking pre and post-operative blood and urine samples during the patient’s admission for cardiac surgery.
A secondary aim of the study will be to identify early markers of AKI that might allow for earlier therapeutic intervention. Hence we will measure several biomarkers of renal injury post-operatively. The study is funded by the William Harvey Research Institute and patients will be recruited from Bart’s Health NHS Trust.
REC name
London - Queen Square Research Ethics Committee
REC reference
15/LO/1741
Date of REC Opinion
20 Oct 2015
REC opinion
Favourable Opinion