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01.09.2015 | Original Article

Interleukin-6 and interleukin-10 as acute kidney injury biomarkers in pediatric cardiac surgery

verfasst von: Jason H. Greenberg, Richard Whitlock, William R. Zhang, Heather R. Thiessen-Philbrook, Michael Zappitelli, Prasad Devarajan, John Eikelboom, Peter A. Kavsak, P. J. Devereaux, Colleen Shortt, Amit X. Garg, Chirag R. Parikh, for the TRIBE-AKI Consortium

Erschienen in: Pediatric Nephrology | Ausgabe 9/2015

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Abstract

Background

Children undergoing cardiac surgery may exhibit a pronounced inflammatory response to cardiopulmonary bypass (CPB). Inflammation is recognized as an important pathophysiologic process leading to acute kidney injury (AKI). The aim of this study was to evaluate the association of the inflammatory cytokines interleukin (IL)-6 and IL-10 with AKI and other adverse outcomes in children after CPB surgery.

Methods

This is a sub-study of the Translational Research Investigating Biomarker Endpoints in AKI (TRIBE-AKI) cohort, including 106 children ranging in age from 1 month to 18 years undergoing CPB. Plasma IL-6 and IL-10 concentrations were measured preoperatively and postoperatively [day 1 (within 6 h after surgery) and day 3].

Results

Stage 2/3 AKI, defined by at least a doubling of the baseline serum creatinine concentration or dialysis, was diagnosed in 24 (23 %) patients. The preoperative IL-6 concentration was significantly higher in patients with stage 2/3 AKI [median 2.6 pg/mL, interquartile range (IQR) 2.6 0.6–4.9 pg/mL] than in those without stage 2/3 AKI (median 0.6 pg/mL, IQR 0.6–2.2 pg/mL) (p = 0.03). After adjustment for clinical and demographic variables, the highest preoperative IL-6 tertile was associated with a sixfold increased risk for stage 2/3 AKI compared with the lowest tertile (adjusted odds ratio 6.41, 95 % confidence interval 1.16–35.35). IL-6 and IL-10 levels increased significantly after surgery, peaking postoperatively on day 1. First postoperative IL-6 and IL-10 measurements did not significantly differ between patients with stage 2/3 AKI and those without stage 2/3 AKI. The elevated IL-6 level on day 3 was associated with longer hospital stay (p = 0.0001).

Conclusions

Preoperative plasma IL-6 concentration is associated with the development of stage 2/3 AKI and may be prognostic of resource utilization.

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Titel: Interleukin-6 and interleukin-10 as acute kidney injury biomarkers in pediatric cardiac surgery
verfasst von: Jason H. Greenberg
Richard Whitlock
William R. Zhang
Heather R. Thiessen-Philbrook
Michael Zappitelli
Prasad Devarajan
John Eikelboom
Peter A. Kavsak
P. J. Devereaux
Colleen Shortt
Amit X. Garg
Chirag R. Parikh
for the TRIBE-AKI Consortium
Publikationsdatum: 01.09.2015
Verlag: Springer Berlin Heidelberg
Erschienen in: Pediatric Nephrology / Ausgabe 9/2015
Print ISSN: 0931-041X
Elektronische ISSN: 1432-198X
DOI: https://doi.org/10.1007/s00467-015-3088-4

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Interleukin-6 and interleukin-10 as acute kidney injury biomarkers in pediatric cardiac surgery