Effects of continuous renal replacement therapy on renal inflammatory cytokines during extracorporeal membrane oxygenation in a porcine model

Background: Extracorporeal membrane oxygenation (ECMO) has been recommended for the treatment of patients with acute, potentially reversible, life-threatening respiratory failure which unresponsive to conventional therapy. But it is unclear about how ECMO affects renal tissue. Methods: Twenty-four piglets weighing 25 to 32 kg were used in this experiment. The piglets were randomly allocated to 4 groups of 6 animals each: sham group (S group), control group (C group), W-ECMO group (E group), W-ECMO combined with CRRT group (EC group). The piglets were sacrificed and the kidney tissue were harvest to determine the levels of IL-1 beta, IL-6, TNF-alpha and NF-kappa B by using the ELISA and RT-PCR method, respectively. Results: Compared with C group and S group, E group renal tissue IL-1 beta, IL-6, TNF-alpha and NF-kappa B expression increased significantly, respectively (p < 0.01). Compared with E group, EC group showed renal tissue IL-1 alpha, IL-6, TNF-alpha and NF-kappa B expression decreased significantly, respectively (p < 0.05). Conclusion: ECMO enables to inflammatory cytokines including IL-1 alpha, IL-6, TNF alpha, NF-kappa B released significantly, renal function impaired and immune homeostasis were to imbalance; ECMO combined with CRRT treatment can alleviate levels of inflammatory cytokines, maintain immune homeostasis balance and thus ameliorate the ECMO-related acute kidney injury(AKI).