Blood and urinary cytokine balance and renal outcomes at cardiac surgery
Increased perioperative pro-inflammatory biomarkers, renal hypoperfusion and ischemia reperfusion injury (IRI) heighten cardiac surgery acute kidney injury (CS-AKI) risk. Increased urinary anti-inflammatory cytokines attenuate risk. We evaluated whether blood and urinary anti-inflammatory biomarkers...
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| Published in | BMC nephrology Vol. 22; no. 1; p. 406 |
|---|---|
| Main Authors | , , , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
England
BioMed Central Ltd
08.12.2021
BioMed Central BMC |
| Subjects | |
| Online Access | Get full text |
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| Abstract | Increased perioperative pro-inflammatory biomarkers, renal hypoperfusion and ischemia reperfusion injury (IRI) heighten cardiac surgery acute kidney injury (CS-AKI) risk. Increased urinary anti-inflammatory cytokines attenuate risk. We evaluated whether blood and urinary anti-inflammatory biomarkers, when expressed as ratios with biomarkers of inflammation, hypoperfusion and IRI are increased in CS-AKI patients.
Preoperative and 24-h postoperative blood and urinary pro-inflammatory and anti-inflammatory cytokines, blood VEGF and H-FABP (hypoperfusion biomarkers), and MK, a biomarker for IRI, were measured in 401 cardiac surgery patients. Pre- and postoperative concentrations of biomarkers and selected ratios thereof, were compared between non-CS-AKI and CS-AKI patients.
Compared with non-CS-AKI, blood pro-inflammatory (pre- and post-op TNFα, IP-10, IL-12p40, MIP-1α, NGAL; pre-op IL-6; post-op IL-8, MK) and anti-inflammatory (pre- and post-op sTNFsr1, sTNFsr2, IL-1RA) biomarkers together with urinary pro-inflammatory (pre- and post-op uIL-12p40; post-op uIP-10, uNGAL) and anti-inflammatory (pre- and post-op usTNFsr1, usTNFsr2, uIL-1RA) biomarkers, were significantly higher in CS-AKI patients. Urinary anti-inflammatory biomarkers, when expressed as ratios with biomarkers of inflammation (blood and urine), hypoperfusion (blood H-FABP and VEGF) and IRI (blood MK) were decreased in CS-AKI. In contrast, blood anti-inflammatory biomarkers expressed as similar ratios with blood biomarkers were increased in CS-AKI.
The urinary anti-inflammatory response may protect against the injurious effects of perioperative inflammation, hypoperfusion and IRI. These finding may have clinical utility in bioprediction and earlier diagnosis of CS-AKI and informing future therapeutic strategies for CS-AKI patients. |
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| AbstractList | Increased perioperative pro-inflammatory biomarkers, renal hypoperfusion and ischemia reperfusion injury (IRI) heighten cardiac surgery acute kidney injury (CS-AKI) risk. Increased urinary anti-inflammatory cytokines attenuate risk. We evaluated whether blood and urinary anti-inflammatory biomarkers, when expressed as ratios with biomarkers of inflammation, hypoperfusion and IRI are increased in CS-AKI patients. Preoperative and 24-h postoperative blood and urinary pro-inflammatory and anti-inflammatory cytokines, blood VEGF and H-FABP (hypoperfusion biomarkers), and MK, a biomarker for IRI, were measured in 401 cardiac surgery patients. Pre- and postoperative concentrations of biomarkers and selected ratios thereof, were compared between non-CS-AKI and CS-AKI patients. Compared with non-CS-AKI, blood pro-inflammatory (pre- and post-op TNF[alpha], IP-10, IL-12p40, MIP-1[alpha], NGAL; pre-op IL-6; post-op IL-8, MK) and anti-inflammatory (pre- and post-op sTNFsr1, sTNFsr2, IL-1RA) biomarkers together with urinary pro-inflammatory (pre- and post-op uIL-12p40; post-op uIP-10, uNGAL) and anti-inflammatory (pre- and post-op usTNFsr1, usTNFsr2, uIL-1RA) biomarkers, were significantly higher in CS-AKI patients. Urinary anti-inflammatory biomarkers, when expressed as ratios with biomarkers of inflammation (blood and urine), hypoperfusion (blood H-FABP and VEGF) and IRI (blood MK) were decreased in CS-AKI. In contrast, blood anti-inflammatory biomarkers expressed as similar ratios with blood biomarkers were increased in CS-AKI. The urinary anti-inflammatory response may protect against the injurious effects of perioperative inflammation, hypoperfusion and IRI. These finding may have clinical utility in bioprediction and earlier diagnosis of CS-AKI and informing future therapeutic strategies for CS-AKI patients. BACKGROUNDIncreased perioperative pro-inflammatory biomarkers, renal hypoperfusion and ischemia reperfusion injury (IRI) heighten cardiac surgery acute kidney injury (CS-AKI) risk. Increased urinary anti-inflammatory cytokines attenuate risk. We evaluated whether blood and urinary anti-inflammatory biomarkers, when expressed as ratios with biomarkers of inflammation, hypoperfusion and IRI are increased in CS-AKI patients.METHODSPreoperative and 24-h postoperative blood and urinary pro-inflammatory and anti-inflammatory cytokines, blood VEGF and H-FABP (hypoperfusion biomarkers), and MK, a biomarker for IRI, were measured in 401 cardiac surgery patients. Pre- and postoperative concentrations of biomarkers and selected ratios thereof, were compared between non-CS-AKI and CS-AKI patients.RESULTSCompared with non-CS-AKI, blood pro-inflammatory (pre- and post-op TNFα, IP-10, IL-12p40, MIP-1α, NGAL; pre-op IL-6; post-op IL-8, MK) and anti-inflammatory (pre- and post-op sTNFsr1, sTNFsr2, IL-1RA) biomarkers together with urinary pro-inflammatory (pre- and post-op uIL-12p40; post-op uIP-10, uNGAL) and anti-inflammatory (pre- and post-op usTNFsr1, usTNFsr2, uIL-1RA) biomarkers, were significantly higher in CS-AKI patients. Urinary anti-inflammatory biomarkers, when expressed as ratios with biomarkers of inflammation (blood and urine), hypoperfusion (blood H-FABP and VEGF) and IRI (blood MK) were decreased in CS-AKI. In contrast, blood anti-inflammatory biomarkers expressed as similar ratios with blood biomarkers were increased in CS-AKI.CONCLUSIONSThe urinary anti-inflammatory response may protect against the injurious effects of perioperative inflammation, hypoperfusion and IRI. These finding may have clinical utility in bioprediction and earlier diagnosis of CS-AKI and informing future therapeutic strategies for CS-AKI patients. Background Increased perioperative pro-inflammatory biomarkers, renal hypoperfusion and ischemia reperfusion injury (IRI) heighten cardiac surgery acute kidney injury (CS-AKI) risk. Increased urinary anti-inflammatory cytokines attenuate risk. We evaluated whether blood and urinary anti-inflammatory biomarkers, when expressed as ratios with biomarkers of inflammation, hypoperfusion and IRI are increased in CS-AKI patients. Methods Preoperative and 24-h postoperative blood and urinary pro-inflammatory and anti-inflammatory cytokines, blood VEGF and H-FABP (hypoperfusion biomarkers), and MK, a biomarker for IRI, were measured in 401 cardiac surgery patients. Pre- and postoperative concentrations of biomarkers and selected ratios thereof, were compared between non-CS-AKI and CS-AKI patients. Results Compared with non-CS-AKI, blood pro-inflammatory (pre- and post-op TNFα, IP-10, IL-12p40, MIP-1α, NGAL; pre-op IL-6; post-op IL-8, MK) and anti-inflammatory (pre- and post-op sTNFsr1, sTNFsr2, IL-1RA) biomarkers together with urinary pro-inflammatory (pre- and post-op uIL-12p40; post-op uIP-10, uNGAL) and anti-inflammatory (pre- and post-op usTNFsr1, usTNFsr2, uIL-1RA) biomarkers, were significantly higher in CS-AKI patients. Urinary anti-inflammatory biomarkers, when expressed as ratios with biomarkers of inflammation (blood and urine), hypoperfusion (blood H-FABP and VEGF) and IRI (blood MK) were decreased in CS-AKI. In contrast, blood anti-inflammatory biomarkers expressed as similar ratios with blood biomarkers were increased in CS-AKI. Conclusions The urinary anti-inflammatory response may protect against the injurious effects of perioperative inflammation, hypoperfusion and IRI. These finding may have clinical utility in bioprediction and earlier diagnosis of CS-AKI and informing future therapeutic strategies for CS-AKI patients. Background Increased perioperative pro-inflammatory biomarkers, renal hypoperfusion and ischemia reperfusion injury (IRI) heighten cardiac surgery acute kidney injury (CS-AKI) risk. Increased urinary anti-inflammatory cytokines attenuate risk. We evaluated whether blood and urinary anti-inflammatory biomarkers, when expressed as ratios with biomarkers of inflammation, hypoperfusion and IRI are increased in CS-AKI patients. Methods Preoperative and 24-h postoperative blood and urinary pro-inflammatory and anti-inflammatory cytokines, blood VEGF and H-FABP (hypoperfusion biomarkers), and MK, a biomarker for IRI, were measured in 401 cardiac surgery patients. Pre- and postoperative concentrations of biomarkers and selected ratios thereof, were compared between non-CS-AKI and CS-AKI patients. Results Compared with non-CS-AKI, blood pro-inflammatory (pre- and post-op TNF[alpha], IP-10, IL-12p40, MIP-1[alpha], NGAL; pre-op IL-6; post-op IL-8, MK) and anti-inflammatory (pre- and post-op sTNFsr1, sTNFsr2, IL-1RA) biomarkers together with urinary pro-inflammatory (pre- and post-op uIL-12p40; post-op uIP-10, uNGAL) and anti-inflammatory (pre- and post-op usTNFsr1, usTNFsr2, uIL-1RA) biomarkers, were significantly higher in CS-AKI patients. Urinary anti-inflammatory biomarkers, when expressed as ratios with biomarkers of inflammation (blood and urine), hypoperfusion (blood H-FABP and VEGF) and IRI (blood MK) were decreased in CS-AKI. In contrast, blood anti-inflammatory biomarkers expressed as similar ratios with blood biomarkers were increased in CS-AKI. Conclusions The urinary anti-inflammatory response may protect against the injurious effects of perioperative inflammation, hypoperfusion and IRI. These finding may have clinical utility in bioprediction and earlier diagnosis of CS-AKI and informing future therapeutic strategies for CS-AKI patients. Keywords: Acute kidney injury, Biomarkers, Cytokines, Cardiac surgery, TNFsr2, IL-1RA, IL-12p40, H-FABP, Midkine Abstract Background Increased perioperative pro-inflammatory biomarkers, renal hypoperfusion and ischemia reperfusion injury (IRI) heighten cardiac surgery acute kidney injury (CS-AKI) risk. Increased urinary anti-inflammatory cytokines attenuate risk. We evaluated whether blood and urinary anti-inflammatory biomarkers, when expressed as ratios with biomarkers of inflammation, hypoperfusion and IRI are increased in CS-AKI patients. Methods Preoperative and 24-h postoperative blood and urinary pro-inflammatory and anti-inflammatory cytokines, blood VEGF and H-FABP (hypoperfusion biomarkers), and MK, a biomarker for IRI, were measured in 401 cardiac surgery patients. Pre- and postoperative concentrations of biomarkers and selected ratios thereof, were compared between non-CS-AKI and CS-AKI patients. Results Compared with non-CS-AKI, blood pro-inflammatory (pre- and post-op TNFα, IP-10, IL-12p40, MIP-1α, NGAL; pre-op IL-6; post-op IL-8, MK) and anti-inflammatory (pre- and post-op sTNFsr1, sTNFsr2, IL-1RA) biomarkers together with urinary pro-inflammatory (pre- and post-op uIL-12p40; post-op uIP-10, uNGAL) and anti-inflammatory (pre- and post-op usTNFsr1, usTNFsr2, uIL-1RA) biomarkers, were significantly higher in CS-AKI patients. Urinary anti-inflammatory biomarkers, when expressed as ratios with biomarkers of inflammation (blood and urine), hypoperfusion (blood H-FABP and VEGF) and IRI (blood MK) were decreased in CS-AKI. In contrast, blood anti-inflammatory biomarkers expressed as similar ratios with blood biomarkers were increased in CS-AKI. Conclusions The urinary anti-inflammatory response may protect against the injurious effects of perioperative inflammation, hypoperfusion and IRI. These finding may have clinical utility in bioprediction and earlier diagnosis of CS-AKI and informing future therapeutic strategies for CS-AKI patients. Abstract Background Increased perioperative pro-inflammatory biomarkers, renal hypoperfusion and ischemia reperfusion injury (IRI) heighten cardiac surgery acute kidney injury (CS-AKI) risk. Increased urinary anti-inflammatory cytokines attenuate risk. We evaluated whether blood and urinary anti-inflammatory biomarkers, when expressed as ratios with biomarkers of inflammation, hypoperfusion and IRI are increased in CS-AKI patients. Methods Preoperative and 24-h postoperative blood and urinary pro-inflammatory and anti-inflammatory cytokines, blood VEGF and H-FABP (hypoperfusion biomarkers), and MK, a biomarker for IRI, were measured in 401 cardiac surgery patients. Pre- and postoperative concentrations of biomarkers and selected ratios thereof, were compared between non-CS-AKI and CS-AKI patients. Results Compared with non-CS-AKI, blood pro-inflammatory (pre- and post-op TNFα, IP-10, IL-12p40, MIP-1α, NGAL; pre-op IL-6; post-op IL-8, MK) and anti-inflammatory (pre- and post-op sTNFsr1, sTNFsr2, IL-1RA) biomarkers together with urinary pro-inflammatory (pre- and post-op uIL-12p40; post-op uIP-10, uNGAL) and anti-inflammatory (pre- and post-op usTNFsr1, usTNFsr2, uIL-1RA) biomarkers, were significantly higher in CS-AKI patients. Urinary anti-inflammatory biomarkers, when expressed as ratios with biomarkers of inflammation (blood and urine), hypoperfusion (blood H-FABP and VEGF) and IRI (blood MK) were decreased in CS-AKI. In contrast, blood anti-inflammatory biomarkers expressed as similar ratios with blood biomarkers were increased in CS-AKI. Conclusions The urinary anti-inflammatory response may protect against the injurious effects of perioperative inflammation, hypoperfusion and IRI. These finding may have clinical utility in bioprediction and earlier diagnosis of CS-AKI and informing future therapeutic strategies for CS-AKI patients. Increased perioperative pro-inflammatory biomarkers, renal hypoperfusion and ischemia reperfusion injury (IRI) heighten cardiac surgery acute kidney injury (CS-AKI) risk. Increased urinary anti-inflammatory cytokines attenuate risk. We evaluated whether blood and urinary anti-inflammatory biomarkers, when expressed as ratios with biomarkers of inflammation, hypoperfusion and IRI are increased in CS-AKI patients. Preoperative and 24-h postoperative blood and urinary pro-inflammatory and anti-inflammatory cytokines, blood VEGF and H-FABP (hypoperfusion biomarkers), and MK, a biomarker for IRI, were measured in 401 cardiac surgery patients. Pre- and postoperative concentrations of biomarkers and selected ratios thereof, were compared between non-CS-AKI and CS-AKI patients. Compared with non-CS-AKI, blood pro-inflammatory (pre- and post-op TNFα, IP-10, IL-12p40, MIP-1α, NGAL; pre-op IL-6; post-op IL-8, MK) and anti-inflammatory (pre- and post-op sTNFsr1, sTNFsr2, IL-1RA) biomarkers together with urinary pro-inflammatory (pre- and post-op uIL-12p40; post-op uIP-10, uNGAL) and anti-inflammatory (pre- and post-op usTNFsr1, usTNFsr2, uIL-1RA) biomarkers, were significantly higher in CS-AKI patients. Urinary anti-inflammatory biomarkers, when expressed as ratios with biomarkers of inflammation (blood and urine), hypoperfusion (blood H-FABP and VEGF) and IRI (blood MK) were decreased in CS-AKI. In contrast, blood anti-inflammatory biomarkers expressed as similar ratios with blood biomarkers were increased in CS-AKI. The urinary anti-inflammatory response may protect against the injurious effects of perioperative inflammation, hypoperfusion and IRI. These finding may have clinical utility in bioprediction and earlier diagnosis of CS-AKI and informing future therapeutic strategies for CS-AKI patients. |
| ArticleNumber | 406 |
| Audience | Academic |
| Author | Kurth, Mary Jo Ruddock, Mark W McBride, William T Joseph, Jijin Watt, Joanne Lamont, John V Domanska, Anna McLean, Gavin Fitzgerald, Peter |
| Author_xml | – sequence: 1 givenname: William T surname: McBride fullname: McBride, William T organization: Department of Cardiac Anesthesia, Belfast Health & Social Care Trust, 274 Grosvenor Road, Belfast, Northern Ireland, BT12 6BA, UK – sequence: 2 givenname: Mary Jo surname: Kurth fullname: Kurth, Mary Jo organization: Randox Laboratories Ltd, Clinical Studies Group, 55 Diamond Road, Crumlin, County Antrim, BT29 4QY, Northern Ireland, UK – sequence: 3 givenname: Anna surname: Domanska fullname: Domanska, Anna organization: Randox Laboratories Ltd, Clinical Studies Group, 55 Diamond Road, Crumlin, County Antrim, BT29 4QY, Northern Ireland, UK – sequence: 4 givenname: Joanne surname: Watt fullname: Watt, Joanne organization: Randox Laboratories Ltd, Clinical Studies Group, 55 Diamond Road, Crumlin, County Antrim, BT29 4QY, Northern Ireland, UK – sequence: 5 givenname: Gavin surname: McLean fullname: McLean, Gavin organization: Department of Cardiac Anesthesia, Belfast Health & Social Care Trust, 274 Grosvenor Road, Belfast, Northern Ireland, BT12 6BA, UK – sequence: 6 givenname: Jijin surname: Joseph fullname: Joseph, Jijin organization: Department of Cardiac Anesthesia, Belfast Health & Social Care Trust, 274 Grosvenor Road, Belfast, Northern Ireland, BT12 6BA, UK – sequence: 7 givenname: John V surname: Lamont fullname: Lamont, John V organization: Randox Laboratories Ltd, Clinical Studies Group, 55 Diamond Road, Crumlin, County Antrim, BT29 4QY, Northern Ireland, UK – sequence: 8 givenname: Peter surname: Fitzgerald fullname: Fitzgerald, Peter organization: Randox Laboratories Ltd, Clinical Studies Group, 55 Diamond Road, Crumlin, County Antrim, BT29 4QY, Northern Ireland, UK – sequence: 9 givenname: Mark W surname: Ruddock fullname: Ruddock, Mark W email: mark.ruddock@randox.com organization: Randox Laboratories Ltd, Clinical Studies Group, 55 Diamond Road, Crumlin, County Antrim, BT29 4QY, Northern Ireland, UK. mark.ruddock@randox.com |
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| Keywords | IL-1RA Cytokines TNFsr2 IL-12p40 Acute kidney injury Biomarkers H-FABP Cardiac surgery Midkine |
| Language | English |
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| References_xml | – volume: 66 start-page: 993 year: 2015 ident: 2621_CR1 publication-title: Am J Kidney Dis WB Saunders doi: 10.1053/j.ajkd.2015.06.018 contributor: fullname: J Ho – volume: 1 start-page: 200 year: 2008 ident: 2621_CR3 publication-title: Clin Transl Sci doi: 10.1111/j.1752-8062.2008.00053.x contributor: fullname: VS Vaidya – volume: 24 start-page: 2739 year: 2009 ident: 2621_CR23 publication-title: Nephrol Dial Transpl doi: 10.1093/ndt/gfp159 contributor: fullname: SM Bagshaw – volume: 27 start-page: 81 year: 2004 ident: 2621_CR11 publication-title: Cytokine. doi: 10.1016/j.cyto.2004.03.018 contributor: fullname: WT McBride – volume: 61 start-page: 275 year: 2013 ident: 2621_CR7 publication-title: Cytokine. doi: 10.1016/j.cyto.2012.10.008 contributor: fullname: WT McBride – volume: 111 start-page: 23 year: 2008 ident: 2621_CR25 publication-title: Cardiology doi: 10.1159/000113423 contributor: fullname: AP Chirumamilla – volume: 88 start-page: 330 year: 2002 ident: 2621_CR13 publication-title: Br J Anaesth doi: 10.1093/bja/88.3.330 contributor: fullname: RC Baker – volume: 130 start-page: 461 year: 1999 ident: 2621_CR24 publication-title: Ann Intern Med doi: 10.7326/0003-4819-130-6-199903160-00002 contributor: fullname: AS Levey – volume: 135 start-page: e945 year: 2015 ident: 2621_CR2 publication-title: Pediatr Am Acad Pediatr contributor: fullname: EM Bucholz – volume: 75 start-page: 724 year: 1995 ident: 2621_CR8 publication-title: Br J Anaesth doi: 10.1093/bja/75.6.724 contributor: fullname: WT McBride – ident: 2621_CR6 doi: 10.1016/j.lfs.2003.08.001 – volume: 19 start-page: 789 year: 2008 ident: 2621_CR15 publication-title: Nephrology contributor: fullname: PP Wolkow – volume: 85 start-page: 431 year: 2014 ident: 2621_CR17 publication-title: Kidney Int doi: 10.1038/ki.2013.333 contributor: fullname: JM Arthur – volume: 30 start-page: 295 year: 2016 ident: 2621_CR19 publication-title: J Diabetes Complications doi: 10.1016/j.jdiacomp.2015.11.020 contributor: fullname: EN De Melo – volume: 167 start-page: 3463 year: 2001 ident: 2621_CR4 publication-title: J Immunol doi: 10.4049/jimmunol.167.6.3463 contributor: fullname: W Sato – volume: 93 start-page: 1210 year: 2000 ident: 2621_CR10 publication-title: Anesthesiology. doi: 10.1097/00000542-200011000-00013 contributor: fullname: SMC Gormley – volume: 83 start-page: 578 year: 2007 ident: 2621_CR12 publication-title: Ann Thorac Surg doi: 10.1016/j.athoracsur.2006.09.041 contributor: fullname: SJ Allen – volume: 7 start-page: 438 year: 1999 ident: 2621_CR14 publication-title: Exp Nephrol doi: 10.1159/000020623 contributor: fullname: PK Chatterjee – volume: 4 start-page: 20 year: 2015 ident: 2621_CR20 publication-title: J Ren Inj Prev contributor: fullname: M Malek – volume: 9 start-page: 1 year: 2019 ident: 2621_CR9 publication-title: Nat Publ Group contributor: fullname: WT McBride – volume: 8 start-page: 7577 year: 2015 ident: 2621_CR21 publication-title: Int J Clin Exp Med contributor: fullname: H Peng – volume: 109 start-page: e102 year: 2008 ident: 2621_CR5 publication-title: Nephron Exp Nephrol doi: 10.1159/000142934 contributor: fullname: GR Kinsey – volume: 64 start-page: 99 year: 2014 ident: 2621_CR18 publication-title: Comp Med contributor: fullname: NA Kirby – volume: 18 start-page: 343 year: 1987 ident: 2621_CR16 publication-title: Gen Pharmacol Pergamon doi: 10.1016/0306-3623(87)90088-7 contributor: fullname: V Bocci – ident: 2621_CR22 doi: 10.1159/000313737 |
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| Snippet | Increased perioperative pro-inflammatory biomarkers, renal hypoperfusion and ischemia reperfusion injury (IRI) heighten cardiac surgery acute kidney injury... Abstract Background Increased perioperative pro-inflammatory biomarkers, renal hypoperfusion and ischemia reperfusion injury (IRI) heighten cardiac surgery... Background Increased perioperative pro-inflammatory biomarkers, renal hypoperfusion and ischemia reperfusion injury (IRI) heighten cardiac surgery acute kidney... BACKGROUNDIncreased perioperative pro-inflammatory biomarkers, renal hypoperfusion and ischemia reperfusion injury (IRI) heighten cardiac surgery acute kidney... Abstract Background Increased perioperative pro-inflammatory biomarkers, renal hypoperfusion and ischemia reperfusion injury (IRI) heighten cardiac surgery... |
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| SubjectTerms | Acute kidney injury Acute Kidney Injury - blood Acute Kidney Injury - urine Acute renal failure Aged Biomarkers Biomarkers - blood Biomarkers - urine Blood Cardiac surgery Cardiac Surgical Procedures Causes of Complications Cytokines Cytokines - blood Cytokines - urine Diabetes Fatty acid-binding protein Female Health aspects Heart Heart surgery Humans Hypotheses IL-1RA Inflammation Interleukin 1 receptor antagonist Interleukin 1 receptors Interleukin 12 Interleukin 6 Interleukin 8 IP-10 protein Ischemia Kidney diseases Laboratories Male Middle Aged Nephrology Patients Plasma Postoperative Complications - blood Postoperative Complications - urine Prevention Proteins Reperfusion Risk factors Statistical analysis Surgery TNFsr2 Tumor necrosis factor-TNF Tumor necrosis factor-α Urine Vascular endothelial growth factor |
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| Title | Blood and urinary cytokine balance and renal outcomes at cardiac surgery |
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