Exploring the Interplay of HIF-1α Expression and its Correlation with Selected Biomarkers in Acute Kidney Injury Patients

Background: Acute Kidney Injury (AKI) is a complex and heterogeneous clinical syndrome, characterized by the sudden decline in renal function, and has greatly contributed to worldwide mortality and morbidity. Its incidence is 68.55% in Pakistan and is still on the rise. The study intended to the analysis of gene expression of HIF-1α and correlate it with the expression of a chosen kidney injury biomarker panel comprising of NGAL, KIM-1 and L-FABP in AKI patients. Materials and methods: Out of blood samples of 50 patients enrolled with AKI in our study, 14 patients with superimposition of acute-on-chronic kidney injury (males n=5; females n=9) were selected along with blood samples of 4 healthy controls (males n=2; females n=2). Their RNA was isolated and mRNA gene expression was quantified by RT-PCR. Results: Analysis showed that HIF-1α expression significantly correlated positively with NGAL (r=0.8829, p=<0.0001) and KIM-1 (r=0.9199, p=<0.0001) mRNA gene fold expression in all male and female AKI on CKD patients, whereas, only the expression of L-FABP in males (r=0.9535, p=0.012) positively correlated with HIF-1α and there was no correlation of it in females (r=0.4067, p=0.2774). Conclusion: We concluded that a positive correlation of all these kidney injury biomarkers in all patients and L-FABP in males suggested that comorbidities such as heart disease, hypertension, diabetes mellitus, sepsis and liver disease produce hypoxic cellular conditions in the sensitive medulla of the kidney, damaging it easily, and can worsen renal function unless treated properly.