title: Acute renal dysfunction after cardiac surgery with cardiopulmonary bypass is associated with plasmatic IL6 increase.
abstract: 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.
authors.affiliation: Anesthesiology and Critical Care Department, Centre Hospitalier Universitaire, 29609 Brest, France. gildas.gueret@chu-brest.fr
authors.forename: Gildas
authors.initials: G
authors.lastname: Gueret
authors.forename: Francois
authors.initials: F
authors.lastname: Lion
authors.forename: Nathalie
authors.initials: N
authors.lastname: Guriec
authors.forename: Josiane
authors.initials: J
authors.lastname: Arvieux
authors.forename: Annabelle
authors.initials: A
authors.lastname: Dovergne
authors.forename: Catherine
authors.initials: C
authors.lastname: Guennegan
authors.forename: Eric
authors.initials: E
authors.lastname: Bezon
authors.forename: Raoul
authors.initials: R
authors.lastname: Baron
authors.forename: Jean-Luc
authors.initials: JL
authors.lastname: Carre
authors.forename: Charles
authors.initials: C
authors.lastname: Arvieux
mesh_terms: 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
chemical_list: D015850:Interleukin-6; D014508:Urea; D003404:Creatinine