Balanced forced-diuresis compared to control as a reno-protective approach in cardiac surgery: secondary outcome of a randomized controlled trial, assessment of neutrophil gelatinase-associated lipocalin levels.
Acute kidney injury
Balanced forced-diuresis
Cardiac surgery
Neutrophil gelatinase-associated lipocalin
RenalGuard® system
Journal
Journal of cardiothoracic surgery
ISSN: 1749-8090
Titre abrégé: J Cardiothorac Surg
Pays: England
ID NLM: 101265113
Informations de publication
Date de publication:
24 Aug 2021
24 Aug 2021
Historique:
received:
25
02
2021
accepted:
12
08
2021
entrez:
25
8
2021
pubmed:
26
8
2021
medline:
16
10
2021
Statut:
epublish
Résumé
Neutrophil gelatinase-associated lipocalin (NGAL) is a recognised biomarker for acute kidney injury (AKI).This study investigated the impact of balanced forced-diuresis using RenalGuard® system (RG), in reducing acute kidney injury (AKI) rates and the associated NGAL levels (6-h post-CPB plasma level) post adult cardiac surgery with cardiopulmonary bypass (CPB). Patients included in the study were at high-risk for AKI post cardiac surgery, namely history of diabetes and/or anaemia, e-GFR 20-60 ml/min/1.73 m Pre and intra-operative characteristics between the two groups were similar (p > 0.05) including the pre-op NGAL levels, the oxygen delivery (ecDO Overall, the 6-h post-CPB plasma NGAL levels were significantly higher in patients who developed AKI. Patients managed with the novel approach of balanced forced-diuresis, provided by the RenalGuard® system, had a lower AKI rate and lower NGAL levels indicating a lesser degree of renal tissue injury. Trial registration ClinicalTrials.gov website, NCT02974946, https://clinicaltrials.gov/ct2/show/NCT02974946 .
Sections du résumé
BACKGROUND
BACKGROUND
Neutrophil gelatinase-associated lipocalin (NGAL) is a recognised biomarker for acute kidney injury (AKI).This study investigated the impact of balanced forced-diuresis using RenalGuard® system (RG), in reducing acute kidney injury (AKI) rates and the associated NGAL levels (6-h post-CPB plasma level) post adult cardiac surgery with cardiopulmonary bypass (CPB).
METHODS
METHODS
Patients included in the study were at high-risk for AKI post cardiac surgery, namely history of diabetes and/or anaemia, e-GFR 20-60 ml/min/1.73 m
RESULTS
RESULTS
Pre and intra-operative characteristics between the two groups were similar (p > 0.05) including the pre-op NGAL levels, the oxygen delivery (ecDO
CONCLUSIONS
CONCLUSIONS
Overall, the 6-h post-CPB plasma NGAL levels were significantly higher in patients who developed AKI. Patients managed with the novel approach of balanced forced-diuresis, provided by the RenalGuard® system, had a lower AKI rate and lower NGAL levels indicating a lesser degree of renal tissue injury. Trial registration ClinicalTrials.gov website, NCT02974946, https://clinicaltrials.gov/ct2/show/NCT02974946 .
Identifiants
pubmed: 34429137
doi: 10.1186/s13019-021-01620-w
pii: 10.1186/s13019-021-01620-w
pmc: PMC8386062
doi:
Substances chimiques
Acute-Phase Proteins
0
Biomarkers
0
Lipocalin-2
0
Lipocalins
0
Proto-Oncogene Proteins
0
Creatinine
AYI8EX34EU
Banques de données
ClinicalTrials.gov
['NCT02974946']
Types de publication
Journal Article
Randomized Controlled Trial
Langues
eng
Sous-ensembles de citation
IM
Pagination
240Subventions
Organisme : National Institute for Health Research
ID : NIHR ID: 32769
Informations de copyright
© 2021. The Author(s).
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