Mitochondrial-Directed Therapy in Prevention of CABG-Associated AKI: mtDNA as Early Biomarker

Tuesday, March 24, 2026

11:15 AM - 12:15 PM Central Time

Location: Connections Central - RST 02

VK

Vicky Kumar, N/A (he/him/his)

Virginia

Disclosure(s): No relevant financial relationship(s) to disclose.
Naoki Hayase, n/a (he/him/his)

National Institutes of Health, Maryland

Disclosure(s): No relevant financial relationship(s) to disclose.
ES

Eduard R. Shaykhinurov, N/A

District of Columbia

Disclosure(s): No relevant financial relationship(s) to disclose.
HS

Huma Saleem, n/a

Study Coordinator
Department of Anesthesiology and Critical Care Medicine, The George Washington Medical Faculty Associates

Disclosure information not submitted.
sa

seda akben, N/A (she/her/hers)

Ankara, TUR

Disclosure(s): No relevant financial relationship(s) to disclose.
GD

Gregory Dawson, MD

Anesthesiology Resident
Department of Anesthesiology and Critical Care Medicine, The George Washington Medical Faculty Associates

Disclosure information not submitted.
SS

Sophia Song, N/A

Medical Student
George Washington University School of Medicine and Health Sciences

Disclosure information not submitted.
ET

Emily Teehan, N/A

Medical Student
George Washington University School of Medicine and Health Sciences

Disclosure information not submitted.
TA

Tebianne Abubaker, MD

Resident Physician
George Washington University

Disclosure information not submitted.
JP

John Perkins, N/A

Laboratory Scientist
George Washington University, Division of Genomic Medicine

Disclosure information not submitted.
EF

Evelyn Fox, MSN

Cardiac Surgery Nurse Navigator
The George Washington University Hospital

Disclosure information not submitted.
KH

Katrina Hawkins, MD

Physician, Critical Care
George Washington University Hospital

Disclosure information not submitted.
MA

Mustafa Al-Mashat, MD

Physician, Critical Care
Department of Anesthesiology and Critical Care Medicine, The George Washington Medical Faculty Associates

Disclosure information not submitted.
DY

David Yamane, MD

Associate Professor
George Washington University

Disclosure information not submitted.
PM

Phillip Ma, MD

Assistant Research Professor of Clinical Research and Leadership
George Washington University

Disclosure information not submitted.
PY

Peter Yuen, N/A

Staff Scientist
Renal Diagnostics and Therapeutics Unit, National Institute of Diabetes, Digestive and Kidney Diseases, National Institutes of Health

Disclosure information not submitted.
Danielle Davison, MD (she/her/hers)

George Washington University Hospital, District of Columbia

Disclosure information not submitted.
YA

Yoosif Abdalla, MD

Director, Critical Care Nephrology
George Washington University

Disclosure information not submitted.

Introduction: Acute kidney injury (AKI) is a serious complication of coronary artery bypass graft (CABG), occurring in up to 30% of patients. Renal ischemia-reperfusion injury (IRI) is a major contributor. Preclinical data suggest antioxidants like CoQ10 and GSH can protect against renal IRI, but human studies are lacking. We hypothesize that perioperative supplementation attenuates IRI-induced AKI.

Methods: This is a double-blinded RCT involving patients (age 18-70) undergoing CABG with glomerular filtration rate ≥ 45 mL/min. Patients were randomized (1:1) to either a placebo or daily CoQ10 and GSH starting the day before surgery and up to post-op day 5. Blood and urine samples were collected preoperatively, on the day of surgery, and 24 hours postoperatively. The primary outcome was AKI incidence during the first 7 days defined by KDIGO criteria. DNA was isolated and absolute quantification was performed by qPCR. Mann-Whitney U tests and Fisher’s exact tests were used for statistical analyses.

Results: Among 16 patients (7 in the treatment group and 9 in the placebo group), the incidence of AKI was 28.6% in the treatment group and 55.6% in the placebo group (RR 0.51, 95% CI 0.14-1.62, p=0.358). Urinary mitochondrial DNA (mtDNA) levels from Day -1 to Day 1 showed no statistically significant association with the development of AKI on any of the seven days (p-values > 0.05). In contrast, plasma mtDNA levels from only Day -1 were significantly elevated in patients who developed AKI on Days 2 to 5 (p = 0.0167, 0.0198, 0.0036, and 0.0036, respectively).

Conclusions: Elevated plasma mtDNA levels on the day before surgery were significantly associated with AKI development between Days 2 and 5. In contrast, urinary mtDNA did not predict AKI. These findings suggest that preclinical elevations in blood mtDNA may serve as an early biomarker for impending AKI in patients undergoing CABG.