Dynamics of innate immunity parameters in acute kidney injury after coronary artery bypass grafting

Abstract

Acute kidney injury (AKI) developing after cardiac surgery remains unsolved issue despite the high level of surgical techniques as well as organ and tissue protection during artificial blood circulation. Various publications demonstrate that complications emerge in as many as 42% cases, whereas renal replacement therapy is required in up to 1-8% cases. Systemic inflammatory response syndrome and activation of the blood coagulation system largely underlie developing AKI finally resulting in acute renal failure. Release of large amounts of cytokines is associated with subclinical renal damage, primarily with blocking renal glomerular filtration. Measuring concentration of serum inflammatory markers that could reflect activity of inflammatory events is crucial for predicting and selecting treatment methods as well as for identifying predictors of severe course with opportunity of early onset renal replacement therapy after hospitalization. Objective of our study was to assess diagnostic and prognostic value of innate immunity parameters such as interleukin (IL) 6, 8, 10, 17, tumor necrosis factor alpha (TNFα), growth factor TGF-β1 in patients with acute kidney injury before and after CABG. Blood serum samples collected from 120 patients (males and females) with ischemic heart disease (IHD) were examined before and after CABG. It was found that patients with acute kidney injury had elevated serum level of cytokines IL-6, IL-8, IL-10, IL-17, TNFα, and TGF-β1 in all groups on day 1 and day 2 after surgery. Hence, we provided the data on more detailed investigation of immune alterations in cardiosurgical patients with AKI prepared for planned CABG.