FGA Serves as a Potential Diagnostic Marker and Therapeutic Target for Elderly Acute Kidney Injury

To identify potential biomarkers and explore the underlying
mechanisms
of elderly acute kidney injury (e-AKI), we performed integrative plasma
proteomics analysis on samples from 20 e-AKI patients and 20 age-matched
non-AKI controls. Differential expression gene analysis, GSEA, WGCNA,
random forest, and LASSO models were employed to identify hub genes,
coupled with immune cell infiltration and clinicopathological correlation
analyses. A renal ischemia–reperfusion injury mouse model validated
key genes at protein and mRNA levels, while in vitro experiments explored
the pathway involvement. We identified 229 e-AKI-associated genes
enriched in immune, inflammatory, and coagulation pathways. Machine
learning combined with the Nephroseq database yielded three hub genes;
in vivo and in vitro experiments confirmed fibrinogen alpha chain
(FGA) as the most relevant gene, which may regulate e-AKI progression
via the cAMP/PKA/CREB pathway. Collectively, FGA holds promise as
a diagnostic biomarker and therapeutic target for e-AKI, laying the
theoretical foundation for its mechanistic research.