Clinical significance of changes in plasma mediators and renal hemodynamics in patients with systemic inflammatory response syndrome

Objective:To study the clinical significance of changes in plasma mediators and renal hemodynamics in patients with systemic inflammatory response syndrome (SIRS),and their correlation with the development of acute renal failure(ARF).Methods:Plasma endothelin (ET),tumor necrosis factorα (TNFα) ,and superoxide dismutase (SOD) levels were measured in 26 patients with SIRS and 15 healthy volunteers (control group) by radioimmunoassay,then dynamic scintirenography by Spect and Color Doppler imaging was also performed in these cases.Results:Abnormal dynamic scintirenography could be found in patients during SIRS via Spect and Color Doppler,and it was earlier than the change in routine biochemical parameters,including blood urea nitrogen(BUN),creatinine(Cr) and urine volume.In patients with multiple organ dysfunction syndrome (MODS),levels of ET,TNFα,SOD in renal failure group were significantly higher than that in nonrenal failure group and normal controls( P 0 05 or P 0 01).Conclusions:Plasma ET,TNFα,SOD and renal hemodynamic changes may be useful parameters to reflect renal conditions and prognosis.Scintirenography and Color Doppler is a highly effective,convenient diagnostic method in evaluating the renal function and the blood flow in patients with MODS.