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Research Article
Blood and urinary cytokine balance and renal outcomes at cardiac surgery
Mark Ruddock
Randox Laboratories Ltd
Corresponding Author
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BACKGROUND
Increased perioperative pro-inflammatory biomarkers, renal hypoperfusion and ischemia reperfusion injury (IRI) heighten cardiac surgery acute kidney injury (CS-AKI) risk. Increased urinary anti-inflammatory cytokines attenuate risk. We evaluated whether blood and urinary anti-inflammatory biomarkers, when expressed as ratios with biomarkers of inflammation, hypoperfusion and IRI are increased in CS-AKI patients.
METHODS
Preoperative and 24-hour postoperative blood and urinary pro-inflammatory and anti-inflammatory cytokines, blood VEGF and H-FABP (hypoperfusion biomarkers), and MK, a biomarker for IRI, were measured in 401 cardiac surgery patients. Pre- and postoperative concentrations of biomarkers and selected ratios thereof, were compared between non-CS-AKI and CS-AKI patients.
RESULTS
Compared with non-CS-AKI, blood pro-inflammatory (pre- and post-op TNFα, IP-10, IL-12p40, MIP-1α, NGAL; pre-op IL-6; post-op IL-8, MK) and anti-inflammatory (pre- and post-op sTNFsr1, sTNFsr2, IL-1RA) biomarkers together with urinary pro-inflammatory (pre- and post-op uIL-12p40; post-op uIP-10, uNGAL) and anti-inflammatory (pre- and post-op usTNFsr1, usTNFsr2, uIL-1RA) biomarkers, were significantly higher in CS-AKI patients. Urinary anti-inflammatory biomarkers, when expressed as ratios with biomarkers of inflammation (blood and urine), hypoperfusion (blood H-FABP and VEGF) and IRI (blood MK) were decreased in CS-AKI. In contrast, blood anti-inflammatory biomarkers expressed as similar ratios with blood biomarkers were increased in CS-AKI.
CONCLUSIONS
The urinary anti-inflammatory response may protect against the injurious effects of perioperative inflammation, hypoperfusion and IRI. These finding may have clinical utility in bioprediction and earlier diagnosis of CS-AKI and informing future therapeutic strategies for CS-AKI patients.
Keywords
acute kidney injury, biomarkers, cytokines, cardiac surgery, TNFsr2, IL-1RA, IL-12p40, H-FABP, midkine
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CURRENT STATUS: Under Review
Version 1
Posted 04 Jan, 2021
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Review #1 received
Received 20 Jan, 2021
Reviewer #2 agreed
On 12 Jan, 2021
Reviewer #5 agreed
On 12 Jan, 2021
Reviewer #8 agreed
On 12 Jan, 2021
Reviewer #3 agreed
On 12 Jan, 2021
Reviewer #1 agreed
On 12 Jan, 2021
Reviewer #7 agreed
On 12 Jan, 2021
Reviewer #6 agreed
On 12 Jan, 2021
Reviewers invited
Invitations sent on 12 Jan, 2021
Editor assigned
On 12 Jan, 2021
Editor invited
On 30 Dec, 2020
Submission checks complete
On 30 Dec, 2020
First submitted
On 22 Dec, 2020
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Subject Areas
Cardiac & Cardiovascular Systems
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This preprint is under consideration at Scientific Reports. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research Article
Blood and urinary cytokine balance and renal outcomes at cardiac surgery
Mark Ruddock
Randox Laboratories Ltd
Corresponding Author
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Under Review
Version 1
Posted 04 Jan, 2021
No community comments so far
Review #1 received
Received 20 Jan, 2021
Reviewer #2 agreed
On 12 Jan, 2021
Reviewer #5 agreed
On 12 Jan, 2021
Reviewer #8 agreed
On 12 Jan, 2021
Reviewer #3 agreed
On 12 Jan, 2021
Reviewer #1 agreed
On 12 Jan, 2021
Reviewer #7 agreed
On 12 Jan, 2021
Reviewer #6 agreed
On 12 Jan, 2021
Reviewers invited
Invitations sent on 12 Jan, 2021
Editor assigned
On 12 Jan, 2021
Editor invited
On 30 Dec, 2020
Submission checks complete
On 30 Dec, 2020
First submitted
On 22 Dec, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Cardiac & Cardiovascular Systems
License:
This work is licensed under a CC BY 4.0 License. Read Full License
BACKGROUND
Increased perioperative pro-inflammatory biomarkers, renal hypoperfusion and ischemia reperfusion injury (IRI) heighten cardiac surgery acute kidney injury (CS-AKI) risk. Increased urinary anti-inflammatory cytokines attenuate risk. We evaluated whether blood and urinary anti-inflammatory biomarkers, when expressed as ratios with biomarkers of inflammation, hypoperfusion and IRI are increased in CS-AKI patients.
METHODS
Preoperative and 24-hour postoperative blood and urinary pro-inflammatory and anti-inflammatory cytokines, blood VEGF and H-FABP (hypoperfusion biomarkers), and MK, a biomarker for IRI, were measured in 401 cardiac surgery patients. Pre- and postoperative concentrations of biomarkers and selected ratios thereof, were compared between non-CS-AKI and CS-AKI patients.
RESULTS
Compared with non-CS-AKI, blood pro-inflammatory (pre- and post-op TNFα, IP-10, IL-12p40, MIP-1α, NGAL; pre-op IL-6; post-op IL-8, MK) and anti-inflammatory (pre- and post-op sTNFsr1, sTNFsr2, IL-1RA) biomarkers together with urinary pro-inflammatory (pre- and post-op uIL-12p40; post-op uIP-10, uNGAL) and anti-inflammatory (pre- and post-op usTNFsr1, usTNFsr2, uIL-1RA) biomarkers, were significantly higher in CS-AKI patients. Urinary anti-inflammatory biomarkers, when expressed as ratios with biomarkers of inflammation (blood and urine), hypoperfusion (blood H-FABP and VEGF) and IRI (blood MK) were decreased in CS-AKI. In contrast, blood anti-inflammatory biomarkers expressed as similar ratios with blood biomarkers were increased in CS-AKI.
CONCLUSIONS
The urinary anti-inflammatory response may protect against the injurious effects of perioperative inflammation, hypoperfusion and IRI. These finding may have clinical utility in bioprediction and earlier diagnosis of CS-AKI and informing future therapeutic strategies for CS-AKI patients.
Figure 1
Figure 2