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Interleukin-10 : A Potential Pre-Cannulation Marker for Development of Acute Kidney Injury in Patients Receiving Veno-Arterial Extracorporeal Membrane Oxygenation

Grins, Edgars LU orcid ; Leacche, Marzia ; Shrestha, Nabin Manandhar ; Bjursten, Henrik LU ; Ederoth, Per LU and Jovinge, Stefan LU (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
; ; ; ; and
organization
publishing date
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}},
}