Serum Inflammatory Cytokines and Peritoneal Dialysis in Infants with Acute Renal Failure Following Open Heart Surgery

Abstract

Background: Acute Renal Failure (ARF) is a common complication after open heart surgery with Cardiopulmonary Bypass (CPB) because of the capillary leak syndrome. Peritoneal Dialysis (PD) has been widely used to treat ARF after CPB. In this study, the clearance of inflammatory cytokines of PD in infants with ARF following open heart surgery was investigated. Methods: Twenty-nine infants with ARF following open heart surgery who underwent PD were divided into survival and nonsurvival groups. Clinical records were reviewed to document clinical features, operative procedures, and perioperative courses. The serum inflammatory cytokine levels, including those of Tumor Necrosis Factor (TNF)-a, interleukin (IL)-6, IL-8, and IL-10, were measured perioperatively. Results: There was no difference in the preoperative characters between the 2 groups. Longer CPB time, duration of mechanical ventilation, duration from surgery to the beginning of PD, and higher central venous pressure appeared in the nonsurvival group. The serum concentrations of IL-6 and IL-8 were significantly higher in the nonsurvival group than in the survival group before PD and on PD 1 day, PD 4 days, and PD 7 days, respectively. The serum concentrations of IL-10 were higher in the nonsurvival group than in the survival group on PD day 4 and PD day 7, respectively. There were no significant differences of TNF-a between the 2 groups during the perioperative period and PD. Conclusion: PD could eliminate inflammatory cytokines effectively in patients with mild ARF after open heart surgery.