Key result
Mild preoperative renal dysfunction did not significantly alter the postoperative increase in neutrophil respiratory burst compared to normal controls (72.9% vs 68.1%, P=0.86).
Why the study?
Does mild preoperative renal dysfunction affect neutrophil activity and apoptosis following cardiovascular surgery?
Observational (n=16)
Does mild preoperative renal dysfunction affect neutrophil activity and apoptosis following cardiovascular surgery?
Cardiovascular surgery induces systemic oxidative stress by increasing neutrophil respiratory burst and decreasing apoptosis, with no significant difference observed between patients with normal renal function and those with mild preoperative renal dysfunction.
Answers are grounded in this paper and cite their sources.
Mild renal dysfunction does not modify neutrophil burst after cardiac surgery; leaves open its role in oxidative stress pathways.
Background: Neutrophils are implicated in initiating perioperative inflammation and postoperative outcome, particularly in patients with acute renal failure. The aim of the current study was to assess the role of neutrophil function in patients following cardiovascular surgery with mild preoperative renal dysfunction (PRD). Materials and methods: Patients scheduled for cardiovascular operations were screened for renal function, and divided into those with glomerular filtration rate (GFR) < 60 mL/minute (PRD, n = 9), and GFR > 60 mL/minute (normal controls; [C] n = 7). Neutrophils were isolated from plasma preoperatively, and 2, 24, and 48 hours postoperatively. Neutrophil activity (respiratory burst; RB) and apoptosis were then determined. Results: In the whole population, neutrophil apoptosis decreased from 67% preoperatively, to 42% postoperatively, with no significant difference between the groups (C = 64.8%–41.2%, PRD = 68.2%–42.6%). RB increased by 70% postoperatively in the whole population, with no significant difference between the groups (C = 68.1%, PRD = 72.9%, P = 0.86). Conclusion: Collectively these data demonstrate that, in addition to decreasing neutrophil apoptosis, cardiovascular surgery leads to increased neutrophil RB, thus contributing to postoperative systemic oxidative stress. This can lead to clinically significant complications and tissue damage. Our data also suggest that differences in postoperative inflammation between patients with and without PRD, do not exist, at least in the setting of mild preoperative renal insufficiency.
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Susan Evans (2011) conducted an observational in Cardiovascular surgery (n=16). Mild preoperative renal dysfunction (PRD) vs. Normal renal function (GFR > 60 mL/minute) was evaluated on Postoperative increase in neutrophil respiratory burst (RB) (p=0.86). Mild preoperative renal dysfunction did not significantly alter the postoperative increase in neutrophil respiratory burst compared to normal controls (72.9% vs 68.1%, P=0.86).
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