[Predictive value of plasma cytokines for acute kidney injury following lung resection surgery: prospective observational study].

Abstract

BACKGROUND AND OBJECTIVES:

Patients undergoing lung resection surgery are at risk of developing postoperative acute kidney injury. Determination of cytokine levels allows the detection of an early inflammatory response. We investigated any temporal relationship among perioperative inflammatory status and development of acute kidney injury after lung resection surgery. Furthermore, we evaluated the impact of acute kidney injury on outcome and analyzed the feasibility of cytokines to predict acute kidney injury.

METHODS:

We prospectively analyzed 174 patients scheduled for elective lung resection surgery with intra-operative periods of one-lung ventilation. Fiberoptic broncho-alveolar lavage was performed in each lung before and after one-lung ventilation periods for cytokine analysis. As well, cytokine levels were measured from arterial blood samples at five time points. Acute kidney injury was diagnosed within 48h of surgery based estabilished criteria for its diagnosis. We analyzed the association between acute kidney injury and cardiopulmonary complications, length of intensive care unit and hospital stays, intensive care unit re-admission, and short-term and long-term mortality.

RESULTS:

The incidence of acute kidney injury in our study was 6.9% (12/174). Acute kidney injury patients showed higher plasma cytokine levels after surgery, but differences in alveolar cytokines were not detected. Although no patient required renal replacement therapy, acute kidney injury patients had higher incidence of cardiopulmonary complications and increased overall mortality. Plasma interleukin-6 at 6h was the most predictive cytokine of acute kidney injury (cut-off point at 4.89pg.mL-1).

CONCLUSIONS:

Increased postoperative plasma cytokine levels are associated with acute kidney injury after lung resection surgery in our study, which worsens the prognosis. Plasma interleukin-6 may be used as an early indicator for patients at risk of developing acute kidney injury after lung resection surgery.

• Authors: Cristina Monteserín Matesanz, Francisco de la Gala, Lisa Rancan, Patricia Piñeiro, Carlos Simón, Alberto Tejedor, Elena Vara, Jorge L Gonzalez-Cantero, Ignacio Garutti
• Journal: Brazilian journal of anesthesiology (Elsevier) (Braz J Anesthesiol) 2019 May - Jun Vol. 69 Issue 3 Pg. 242-252 ISSN: 2352-2291 [Electronic] Brazil
• Vernacular Title: Valor preditivo das citocinas plasmáticas para lesão renal aguda após cirurgia de ressecção pulmonar: estudo observacional prospectivo.
• PMID: 31133282 (Publication Type: Journal Article, Observational Study)
• Copyright: Copyright © 2019. Publicado por Elsevier Editora Ltda.

Chemical References

• Cytokines

Topics

• Acute Kidney Injury (diagnosis, epidemiology, etiology)
• Aged
• Bronchoalveolar Lavage
• Cytokines (blood)
• Female
• Humans
• Incidence
• Male
• Middle Aged
• One-Lung Ventilation
• Postoperative Complications (diagnosis, epidemiology)
• Predictive Value of Tests
• Prospective Studies
• Pulmonary Surgical Procedures (adverse effects, methods)