Blood and urinary cytokine balance and renal outcomes at orthopaedic surgery

Blood and urinary cytokine balance and renal outcomes at orthopaedic surgery

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BackgroundIn patients undergoing orthopaedic trauma surgery, acute kidney injury (AKI) can develop post-operatively and is a major cause of increased mortality and hospital stay time.Development of AKI is associated with three main processes: inflammation, ischaemia-reperfusion injury (IRI) and hypoperfusion.In this study, we investigated whether ratios of urine and blood anti-inflammatory biomarkers and biomarkers of hypoperfusion, IRI and inflammation are elevated in patients who develop post-trauma orthopaedic surgery acute kidney injury voyage et cie discount code (PTOS-AKI).

MethodsBlood and urinary biomarkers of inflammation, hypoperfusion and IRI were analysed in 237 patients undergoing orthopaedic fracture surgery pre- and post-operatively.Biomarker ratios were compared between non-PTOS-AKI and PTOS-AKI patients.ResultsMultiple inflammatory biomarkers were significantly elevated in PTOS-AKI patients compared to non-PTOS-AKI patients.

When urine anti-inflammatory biomarkers were expressed as biomarker ratios with biomarkers of inflammation, hypoperfusion and IRI, multiple ratios were lower in PTOS-AKI patients.In contrast, blood anti-inflammatory biomarkers when expressed as ratios with blood proinflammatory biomarkers were elevated in PTOS-AKI patients.DiscussionReductions in ratios of urine anti-inflammatory and proinflammatory biomarkers in PTOS-AKI patients suggest that the renal anti-inflammatory response is protective against the proinflammatory response in patients who do not develop PTOS-AKI.

Detection of proinflammatory and anti-inflammatory biomarkers both pre- and post-operatively may be useful in detecting patients at risk of developing AKI after powell and mahoney bloody mary mix orthopaedic surgery.