• Gildas Gueret, Francois Lion, Nathalie Guriec, Josiane Arvieux, Annabelle Dovergne, Catherine Guennegan, Eric Bezon, Raoul Baron, Jean-Luc Carre, and Charles Arvieux.
• Anesthesiology and Critical Care Department, Centre Hospitalier Universitaire, 29609 Brest, France. gildas.gueret@chu-brest.fr
• Cytokine. 2009 Feb 1; 45 (2): 92-8.

BackgroundAcute 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.MethodsSixty-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).ResultsWithin 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.ConclusionSevere acute renal dysfunction after cardiac surgery with CPB is associated with a significant increased IL-6 systemic production.

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