2000
DOI: 10.1097/00000542-200011000-00013
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Plasma and Urinary Cytokine Homeostasis and Renal Dysfunction during Cardiac Surgery

Abstract: Cardiac surgery using CPB leads to changes in plasma and urinary cytokine homeostasis that correlate with renal proximal tubular dysfunction. This dysfunction may be related to the renal filtration of proinflammatory mediators. Renal autoprotective mechanisms may involve the intrarenal generation of antiinflammatory cytokines.

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Cited by 71 publications
(49 citation statements)
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“…It is well known that the lungs and kidneys are organs at high risk for postoperative dysfunction (1,4,13). The exact role of local cytokine production induced by the CPB procedure remains to be clarified, but the impaired oxygenation found in all CPB-pigs might be a consequence of the inflammatory state manifested as mRNA-cytokine production.…”
Section: Discussionmentioning
confidence: 99%
“…It is well known that the lungs and kidneys are organs at high risk for postoperative dysfunction (1,4,13). The exact role of local cytokine production induced by the CPB procedure remains to be clarified, but the impaired oxygenation found in all CPB-pigs might be a consequence of the inflammatory state manifested as mRNA-cytokine production.…”
Section: Discussionmentioning
confidence: 99%
“…As noted before, the concentration of TNFsr-2 in urine was far in excess of that in plasma and is thought to reflect an intrarenal source for this anti-inflammatory cytokine which provides an intrarenal compensatory and protective response during renal filtration and removal of plasma proinflammatory TNF-␣ [3,10]. Consistent with this reasoning [3,10] is the suggestion that a reduction in plasma TNF-␣ concentrations in the treatment group results in reduced filtered TNF-␣ appearing in the proximal tubule leading to a less intense tubular antiinflammatory compensatory response resulting in lower concentration of urinary TNFsr-2 in the treatment group. The alteration of both plasma and urinary antiinflammatory cytokines in the treatment group strongly confirms our interpretation that a reduced plasma TNF-␣ reflects an overall reduced proinflammatory insult in this group.…”
Section: Management Of Shed Blood and The Inflammatory Responsementioning
confidence: 92%
“…Additionally, a longer CPB time disrupts the normal functioning of kidney, nervous system, and gastrointestinal tract; thus, increases morbidity and mortality after surgery. [23][24][25][26][27][28][29] Gastrointestinal tract vascular integrity and perfusion were disrupted (i.e. sphlanchnic hypoperfusion) by a long CPB time (>90 minutes).…”
Section: Discussionmentioning
confidence: 99%