Interleukin-10 : A Potential Pre-Cannulation Marker for Development of Acute Kidney Injury in Patients Receiving Veno-Arterial Extracorporeal Membrane Oxygenation
(2023) In Blood Purification 52(7-8). p.631-641- Abstract
INTRODUCTION: Acute kidney injury (AKI) in patients treated with veno-arterial extracorporeal membrane oxygenation (VA-ECMO) is associated with high mortality. The objective of this study was to investigate whether cytokine levels before the initiation of ECMO treatment could predict AKI. We also aimed to investigate the impact of AKI on 30-day and 1-year mortality.
METHODS: Serum cytokine levels were analyzed in 100 consecutive VA-ECMO-treated patients at pre-cannulation, at 48 h post-cannulation, and at 8 days. Clinical data to establish the incidence and outcome of AKI after the start of ECMO was retrieved from the local ECMO registry.
SETTING: The study was conducted at tertiary care, university hospital. Participants... (More)
INTRODUCTION: Acute kidney injury (AKI) in patients treated with veno-arterial extracorporeal membrane oxygenation (VA-ECMO) is associated with high mortality. The objective of this study was to investigate whether cytokine levels before the initiation of ECMO treatment could predict AKI. We also aimed to investigate the impact of AKI on 30-day and 1-year mortality.
METHODS: Serum cytokine levels were analyzed in 100 consecutive VA-ECMO-treated patients at pre-cannulation, at 48 h post-cannulation, and at 8 days. Clinical data to establish the incidence and outcome of AKI after the start of ECMO was retrieved from the local ECMO registry.
SETTING: The study was conducted at tertiary care, university hospital. Participants included 100 patients treated with VA-ECMO.
INTERVENTIONS: The blood samples for cytokine analysis were collected before VA-ECMO treatment, at 48 h after VA-ECMO treatment was started, and at 8 days.
RESULTS: Pre-cannulation serum IL-10 levels were significantly higher in patients who developed AKI (212 [38.9, 620.7]) versus those who did not (49.0 [11.9, 102.2]; p = 0.007), and the development of AKI can be predicted by pre-cannulation IL-10 levels (p = 0.025, OR = 1.2 [1.02-1.32]). The development of AKI during ECMO treatment is associated with increased 30-day mortality (p = 0.049) compared to patients who did not develop AKI and had a pre-cannulation estimated glomerular filtration rate ≥ 45 mL/min. The 1-year survival rate for patients with AKI who survived the first 30 days of ECMO treatment is comparable to that of patients without AKI.
CONCLUSION: Increased pre-cannulation IL-10 levels are associated with the development of AKI during VA-ECMO support. AKI is associated with increased 30-day mortality compared to patients with no AKI and better renal function. However, patients with AKI who survive the first 30 days have a 1-year survival rate similar to those without AKI.
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- author
- Grins, Edgars LU ; Leacche, Marzia ; Shrestha, Nabin Manandhar ; Bjursten, Henrik LU ; Ederoth, Per LU and Jovinge, Stefan LU
- organization
- publishing date
- 2023
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Acute kidney injury, Cytokines, Interleukin-10, Newer biomarkers in acute kidney injury, Veno-arterial membrane oxygenation
- in
- Blood Purification
- volume
- 52
- issue
- 7-8
- pages
- 631 - 641
- publisher
- Karger
- external identifiers
-
- scopus:85168812767
- pmid:37586332
- pmid:37586332
- ISSN
- 0253-5068
- DOI
- 10.1159/000531328
- language
- English
- LU publication?
- yes
- additional info
- © 2023 The Author(s). Published by S. Karger AG, Basel.
- id
- 0d8e61f1-64d4-419e-a785-3152314f3913
- date added to LUP
- 2023-08-23 19:33:09
- date last changed
- 2024-04-20 01:25:10
@article{0d8e61f1-64d4-419e-a785-3152314f3913, abstract = {{<p>INTRODUCTION: Acute kidney injury (AKI) in patients treated with veno-arterial extracorporeal membrane oxygenation (VA-ECMO) is associated with high mortality. The objective of this study was to investigate whether cytokine levels before the initiation of ECMO treatment could predict AKI. We also aimed to investigate the impact of AKI on 30-day and 1-year mortality.</p><p>METHODS: Serum cytokine levels were analyzed in 100 consecutive VA-ECMO-treated patients at pre-cannulation, at 48 h post-cannulation, and at 8 days. Clinical data to establish the incidence and outcome of AKI after the start of ECMO was retrieved from the local ECMO registry.</p><p>SETTING: The study was conducted at tertiary care, university hospital. Participants included 100 patients treated with VA-ECMO.</p><p>INTERVENTIONS: The blood samples for cytokine analysis were collected before VA-ECMO treatment, at 48 h after VA-ECMO treatment was started, and at 8 days.</p><p>RESULTS: Pre-cannulation serum IL-10 levels were significantly higher in patients who developed AKI (212 [38.9, 620.7]) versus those who did not (49.0 [11.9, 102.2]; p = 0.007), and the development of AKI can be predicted by pre-cannulation IL-10 levels (p = 0.025, OR = 1.2 [1.02-1.32]). The development of AKI during ECMO treatment is associated with increased 30-day mortality (p = 0.049) compared to patients who did not develop AKI and had a pre-cannulation estimated glomerular filtration rate ≥ 45 mL/min. The 1-year survival rate for patients with AKI who survived the first 30 days of ECMO treatment is comparable to that of patients without AKI.</p><p>CONCLUSION: Increased pre-cannulation IL-10 levels are associated with the development of AKI during VA-ECMO support. AKI is associated with increased 30-day mortality compared to patients with no AKI and better renal function. However, patients with AKI who survive the first 30 days have a 1-year survival rate similar to those without AKI.</p>}}, author = {{Grins, Edgars and Leacche, Marzia and Shrestha, Nabin Manandhar and Bjursten, Henrik and Ederoth, Per and Jovinge, Stefan}}, issn = {{0253-5068}}, keywords = {{Acute kidney injury; Cytokines; Interleukin-10; Newer biomarkers in acute kidney injury; Veno-arterial membrane oxygenation}}, language = {{eng}}, number = {{7-8}}, pages = {{631--641}}, publisher = {{Karger}}, series = {{Blood Purification}}, title = {{Interleukin-10 : A Potential Pre-Cannulation Marker for Development of Acute Kidney Injury in Patients Receiving Veno-Arterial Extracorporeal Membrane Oxygenation}}, url = {{http://dx.doi.org/10.1159/000531328}}, doi = {{10.1159/000531328}}, volume = {{52}}, year = {{2023}}, }