PURPOSE: Protective effect of pulsatile flow cardiopulmonary bypass (CPB) on the occurrence of acute renal injury is still a matter of debate. The objective of this study was to compare the effects of pulsatile and non-pulsatile cardiopulmonary bypass on kidneys using Urinary neutrophil gelatinase-associated lipocalin (NGAL) and interleukin-18 (IL-18) as the markers of renal injury.
METHODS: 85 consecutive patients with normal preoperative renal function were prospectively enrolled in the study. Pulsatile perfusion (Group P) and non-pulsatile perfusion (Group NP) was used in 42 and 43 of the patients, respectively, during aortic cross-clamping period. NGAL and IL-18 were analyzed using ELISA in urine samples obtained preoperatively, and at 2, 12, and 24 h after CPB.
RESULTS: There was no significant difference between the groups in terms of perioperative renal function tests. IL-18 levels measured at 12 h after CPB were significantly lower in Group P, compared to Group NP (p
CONCLUSIONS: Low IL-18 and NGAL levels found in the pulsatile perfusion group might suggest the use of pulsatile flow resulted in better kidney protection.
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