Acute renal dysfunction after cardiac surgery with cardiopulmonary bypass is associated with plasmatic IL6 increase.
BACKGROUND
Acute renal dysfunction (ARD) is common after cardiac surgery with cardiopulmonary bypass (CPB). CPB results in a sudden systemic inflammatory response. Systemic and local pro-inflammatory cytokines synthesis has been linked with sub-clinical renal injury, especially tubular lesions. Therefore, we sought to assess the systemic synthesis pro-inflammatory cytokines and its association with perioperative ARD after cardiac surgery with CPB.


METHODS
Sixty-two patients undergoing cardiac surgery with CPB were prospectively included. Four groups of patients were defined according to blood creatinine increase: no ARD (less than 25% increase), faint ARD (25-50% increase), moderate ARD (50-100% increase), severe ARD (more than 100% increase).


RESULTS
Within the 48 post-operative hours was ARD observed as no dysfunction (41.9%), faint (32.2%), moderate (16.1%), severe (9.6%). One patient had to undergo a dialysis. Pre-operative characteristics were homogenous between the four groups excepted the left ventricle ejection fraction. ARD was associated with a low urinary output with high sodium excretion fraction. Significant increase of IL-6 level occurred when patients underwent a severe ARD despite no significant differences for the CRP and TNF-alpha concentrations.


CONCLUSIONS
Severe acute renal dysfunction after cardiac surgery with CPB is associated with a significant increased IL-6 systemic production.
Gueret
Gildas
G
Anesthesiology and Critical Care Department, Centre Hospitalier Universitaire, 29609 Brest, France. gildas.gueret@chu-brest.fr
Lion
Francois
F
Guriec
Nathalie
N
Arvieux
Josiane
J
Dovergne
Annabelle
A
Guennegan
Catherine
C
Bezon
Eric
E
Baron
Raoul
R
Carre
Jean-Luc
JL
Arvieux
Charles
C
D058186:Acute Kidney Injury / Q000097:blood / Q000209:etiology; D000368:Aged; D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D002315:Cardiopulmonary Bypass / Q000009:adverse effects*; D003404:Creatinine / Q000097:blood; D005260:Female; D006801:Humans; D015850:Interleukin-6 / Q000097:blood*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000097:blood*; D014508:Urea / Q000097:blood
D015850:Interleukin-6; D014508:Urea; D003404:Creatinine