Kidney injury after cardiopulmonary bypass in infants with congenital heart disease
TI Yun-Xing, PAN Zheng-Xia, WU Chun, WANG Gang, LI Hong-Bo, LI Yong-Gang, AN Yong, DAI Jiang-Tao
Key Laboratory of Developmental Diseases in Childhood (Chongqing Medical University), Ministry of Education, Chongqing 400014,China. Email: Panzhengxia@yahoo.com.cn
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.
TI Yun-Xing,PAN Zheng-Xia,WU Chun et al. Kidney injury after cardiopulmonary bypass in infants with congenital heart disease[J]. CJCP, 2011, 13(5): 385-387.
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