title: [Kidney injury after cardiopulmonary bypass in infants with congenital heart disease].
abstract: OBJECTIVE
  To study kidney injury in infants with congenital heart disease (CHD) who underwent cardiac surgery with cardiopulmonary bypass (CPB).
  
  
  METHODS
  Forty CHD infants undergoing cardiac surgery with CPB from October 2009 to July 2010 were enrolled. The concentrations of serum tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), cystatin C (CysC) and urinary N-acetyl-beta-D-glucosaminidase (NAG) were detected using ELISA before bypass, at the end of surgery, and 2 hrs, 6 hrs and 24 hrs after surgery. Serum concentrations of creatinine (Cr) and urea nitrogen (BUN) were measured with conventional biochemistry technique before and after surgery.
  
  
  RESULTS
  The concentrations of serum Cr and BUN were normal before and after surgery. After CPB, the concentrations of serum TNF-α and IL-6 and urinary NAG increased significantly (P<0.05). Serum TNF-α was positively correlated with urinary NAG and serum CysC (r=0.195, 0.190, respectively; both P<0.05). Serum IL-6 was positively correlated with urinary NAG (r=0.278, P<0.01). The positive rate in kidney injury was detected by serum CysC and urinary NAG were significantly higher than by serum Cr or BUN (both P<0.01).
  
  
  CONCLUSIONS
  CPB can cause acute kidney injury in infants, which may be correlated with the increase in the concentrations of serum TNF-α and IL-6. Serum CysC and urinary NAG may be used as sensitive markers for reflecting the changes of renal function.
authors.affiliation: Key Laboratory of Developmental Diseases in Childhood (Chongqing Medical University), Ministry of Education, Chongqing 400014, China.
authors.forename: Yun-Xing
authors.initials: YX
authors.lastname: Ti
authors.forename: Zheng-Xia
authors.initials: ZX
authors.lastname: Pan
authors.forename: Chun
authors.initials: C
authors.lastname: Wu
authors.forename: Gang
authors.initials: G
authors.lastname: Wang
authors.forename: Hong-Bo
authors.initials: HB
authors.lastname: Li
authors.forename: Yong-Gang
authors.initials: YG
authors.lastname: Li
authors.forename: Yong
authors.initials: Y
authors.lastname: An
authors.forename: Jiang-Tao
authors.initials: JT
authors.lastname: Dai
mesh_terms: D000118:Acetylglucosaminidase / Q000652:urine; D058186:Acute Kidney Injury / Q000209:etiology*; D002315:Cardiopulmonary Bypass / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D055316:Cystatin C / Q000097:blood; D005260:Female; D006330:Heart Defects, Congenital / Q000601:surgery*; D006801:Humans; D015850:Interleukin-6 / Q000097:blood; D008297:Male; D014409:Tumor Necrosis Factor-alpha / Q000097:blood
chemical_list: D055316:Cystatin C; D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha; D000118:Acetylglucosaminidase