Inflammation markers in critically ill patients with acute renal failure: correlation with mortality and renal function outcome

• Grant number: 06/01552-3
• Support Opportunities: Regular Research Grants
• Start date: July 01, 2006
• End date: June 30, 2008
• Field of knowledge: Health Sciences - Medicine - Medical Clinics
• Principal Investigator: Luis Yu
• Grantee: Luis Yu
• Host Institution: Faculdade de Medicina (FM). Universidade de São Paulo (USP). São Paulo , SP, Brazil

Abstract

Acute renal failure is a frequent complication occurring in up to 20% of critical patients in the ICU. Mortality rates remain high, between 50 and 80%. ARF is considered a mortality cause rather than an associated comorbidity. ARF critical patients with multiple organ dysfunction syndrome present the highest mortality rates. MODS is associated with systemic inflammation which is an important prognostic factor. Inflammation is involved in renal dysfunction pathogenesis, with renal cells releasing several inflammatory cytokines and chemokines. Systemic levels of cytokines are elevated in ARF due to renal synthesis and reduced renal clearance. Because of the association between persistent inflammatory response activation and MODS, several studies have addressed the role of inflammatory mediators as prognostic predictors in critical patients. The inflammatory mediators profile may be different in ARF patients and may early correlate with renal function outcome and mortality. The objectives of the present study are to correlate inflammatory mediators in critical ARF patients with mortality, prognostic scores, ARF severity and renal function outcome. Clinical and demographic data will be collected and plasma determinations of TNF alfa, TNFR-1, IL-6, IL-8, IL-10, leptin and urine IL-18 will be measured on the day of ARF diagnosis (day 1) and subsequently on days 3 and 5. (AU)