Plasma gelsolin level predicts acute kidney injury after cardiopulmonary bypass in infants and young children
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Acute kidney injury (AKI) after cardiopulmonary bypass (CPB) is a common complication especially in pediatric population. Plasma gelsolin (pGSN) is an anti-inflammatory factor through binding with actin and pro-inflammatory cytokines in circulation. Decrease in pGSN has been reported in some pathologic conditions. The purpose of the study was to determine the alterations of pGSN level in infants and young children after CPB and the role of pGSN as a predictor for the morbidity and severity of post-CPB AKI.
Sixty-seven infants and young children at age ≤ 3 years old undergoing CPB were prospectively enrolled. PGSN levels were measured during peri-operative period with enzyme-linked immuno-sorbent assay and normalized with plasma total protein concentration. Other clinical characteristics of the patients were also recorded.
In patients developing AKI, the normalized pGSN (pGSNN) levels significantly decreased at 6 h post-operation and remained low for 24 h post-operation as compared to the patients with non-AKI. PGSNN at 6 h post-operation combining with CPB time presents an excellent predictive value for AKI.
Decreased pGSNN identifies post-CPB AKI in the patients ≤ 3 years old, and is associated with adverse clinical outcomes. The findings suggest that circulating GSN in post-CPB patients may have beneficial effects on diminishing inflammatory responses.
KeywordsAcute kidney injury Cardiopulmonary bypass Infants Plasma gelsolin Young children
We appreciated sincerely the families and patients who participated in the study, and the physicians, nurses who cared for the study patients. We also grateful to the staffs of the Key Laboratory for Diagnosis and Therapy of Neonatal Diseases, the Children’s Hospital of Zhejiang University School of Medicine serving as scientific advisers.
SSS and XJY participated in the design of the study and drafted the manuscript. JJF and DYZ collected the clinical data and blood samples. XWL carried out the statistical analysis. BLC carried out the ELISA test. JGX and JF helped to draft the manuscript. QS and XMF participated in the design of the study and critical revision of the article for the important content. All authors had read and approved the final manuscript.
This study was supported by grants from National Natural Science Foundation of China (81100050 to Shan-Shan Shi, 81301612 to Xi-Wang Liu), Science and Technology Bureau of Zhejiang Province (2011C23011 to Qiang Shu), Ministry of Education Doctoral Station Foundation (20120101110049 to Qiang Shu), and National Key Technology Support Program (2012BAI04B05 to Qiang Shu).
Compliance with ethical standards
Informed content was obtained from the study patients’ parents, and the study was approved by the Ethics Committee of Children’s Hospital of Zhejiang University School of Medicine.
Conflict of interest
No financial or non-financial benefits have been received or will be received from any party related directly or indirectly to the subject of this article.
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