tailieunhanh - Báo cáo y học: " Urine interleukin-6 is an early biomarker of acute kidney injury in children undergoing cardiac surgery"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học quốc tế cung cấp cho các bạn kiến thức về ngành y đề tài: Urine interleukin-6 is an early biomarker of acute kidney injury in children undergoing cardiac surgery. | Dennen et al. Critical Care 2010 14 R181 http content 14 5 R181 c CRITICAL CARE RESEARCH Open Access Urine interleukin-6 is an early biomarker of acute kidney injury in children undergoing cardiac surgery Paula Dennen1 Christopher Altmann2 Jonathan Kaufman3 Christina L Klein4 Ana Andres-Hernando2 2 2 5 6 2 Nilesh H Ahuja2 Charles L Edelstein2 Melissa A Cadnapaphornchai5 Angela Keniston6 Sarah Faubel2 Abstract Introduction Interleukin-6 IL-6 is a proinflammatory cytokine that increases early in the serum of patients with acute kidney injury AKI . The aim of this study was to determine whether urine IL-6 is an early biomarker of AKI and determine the source of urine IL-6. Numerous proteins including cytokines are filtered by the glomerulus and then endocytosed and metabolized by the proximal tubule. Since proximal tubule injury is a hallmark of AKI we hypothesized that urine IL-6 would increase in AKI due to impaired proximal tubule metabolism of filtered IL-6. Methods Urine was collected in 25 consecutive pediatric patients undergoing cardiac bypass surgery CPB . AKI was defined as a 50 increase in serum creatinine at 24 hours RIFLE Risk Injury Failure Loss End stage R . Mouse models of AKI and freshly isolated proximal tubules were also studied. Results Urine IL-6 increased at six hours in patients with AKI versus no AKI X2 P . Urine IL-6 75 pg mg identified AKI with a sensitivity of 88 . To assess whether increased urine IL-6 occurs in functional versus structural renal failure mouse models of pre-renal azotemia after furosemide injection no tubular injury ischemic AKI tubular injury and cisplatin AKI tubular injury were studied. Urine IL-6 did not significantly increase in pre-renal azotemia but did increase in ischemic and cisplatin AKI. To determine if circulating IL-6 appears in the urine in AKI recombinant human h IL-6 was injected intravenously and urine collected for one hour urine hIL-6 increased in ischemic AKI but not pre-renal