Effects of continuous renal replacement therapy on serum cytokines, neutrophil gelatinase-associated lipocalin, and prognosis in patients with severe acute kidney injury after cardiac surgery

// Heng-jin Wang 1,2,* , Pei Wang 3,* , Nan Li 1,* , Cheng Wan 1 , Chun-ming Jiang 1 , Jing-song He 1 , Dong-jin Wang 4 , Miao Zhang 1 and Ling-yun Sun 2 1 Department of Nephrology, Affiliated Drum Tower Hospital, Medical School of Nanjing University, Nanjing, China 2 Nanjing Drum Tower Hospital, Nanjing Medical University (Nanjing University of Chinese Medicine), Nanjing, China 3 Nanjing Maternity and Child Health Hospital, Nanjing Medical University, Nanjing, China 4 Department of Cardiac Surgery, Affiliated Drum Tower Hospital, Medical School of Nanjing University, Nanjing, China * These authors have contributed equally to this work Correspondence to: Miao Zhang, email: // Keywords : continuous renal replacement therapy; acute kidney injury; multiple organ dysfunction syndrome; cardiac surgery; cytokines Received : July 16, 2016 Accepted : September 08, 2016 Published : November 09, 2016 Abstract The aim of our study was to evaluate the effect of continuous renal replacement therapy (CRRT) on serum cytokines, neutrophil gelatinase-associated lipocalin (NGAL), and prognosis in patients with severe acute kidney injury (AKI) following cardiac surgery. A total number of 153 patients with severe AKI following cardiac surgery were treated with CRRT. They were divided into the survival and non-survival groups. Clinical data from these two groups before and after CRRT were recorded and analyzed. It was found that the number of impaired organs, MODS and APACHE II scores were significantly higher in the non-survival group than those in the survival group before CRRT. After CRRT, MODS and APACHE II scores decreased significantly. The post-CRRT levels of serum TNF-α and IL-6 were significantly decreased. After CRRT, serum NGAL decreased in the two groups, but the levels were higher in the non-survival group than those in the survival group. MODS and APACHE II scores could be used to evaluate the severity of AKI in patients after cardiac surgery. CRRT is an effective treatment for these patients and high levels of TNF-α, IL-6, and NGAL are associated with a poor prognosis in these patients.