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

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.

• Authors: 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, TRIBE-AKI Consortium
• Journal: Pediatric nephrology (Berlin, Germany) (Pediatr Nephrol) Vol. 30 Issue 9 Pg. 1519-27 (Sep 2015) ISSN: 1432-198X [Electronic] Germany
• PMID: 25877915 (Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)

Chemical References

• Biomarkers
• IL10 protein, human
• IL6 protein, human
• Interleukin-6
• Interleukin-10
• Creatinine

Topics

• Acute Kidney Injury (blood, diagnosis, etiology)
• Adolescent
• Biomarkers (blood)
• Canada
• Cardiac Surgical Procedures (adverse effects, methods)
• Cardiopulmonary Bypass (adverse effects)
• Child
• Child, Preschool
• Cohort Studies
• Creatinine (blood)
• Female
• Humans
• Infant
• Interleukin-10 (blood)
• Interleukin-6 (blood)
• Kidney Function Tests (methods)
• Male
• Postoperative Complications (blood, diagnosis, etiology)
• Predictive Value of Tests
• Preoperative Care (methods)
• Prognosis
• Renal Dialysis (statistics & numerical data)
• United States