Biomarker-guided acute kidney injury risk assessment under liberal versus restrictive fluid therapy - the prospective-randomized MAYDAY-trial.
Acute kidney injury
Breast neoplasms/surgery
Breast reconstruction
Fluid therapy
Intraoperative fluid management
Urinary biomarkers
Journal
Scientific reports
ISSN: 2045-2322
Titre abrégé: Sci Rep
Pays: England
ID NLM: 101563288
Informations de publication
Date de publication:
24 Jul 2024
24 Jul 2024
Historique:
received:
28
02
2024
accepted:
19
07
2024
medline:
26
7
2024
pubmed:
26
7
2024
entrez:
24
7
2024
Statut:
epublish
Résumé
Acute kidney injury (AKI) prevalence in surgical patients is high, emphasizing the need for preventative measures. This study addresses the insufficient evidence on nephroprotective intraoperative fluid resuscitation and highlights the drawbacks of relying solely on serum creatinine/urine output to monitor kidney function. This study assessed the impact of intraoperative fluid management on AKI in female breast cancer patients undergoing autologous breast reconstruction, utilizing novel urinary biomarkers (TIMP-2 and IGFBP-7). In a monocentric prospective randomized controlled trial involving 40 patients, liberal (LFA) and restrictive (FRV) fluid management strategies were compared. TIMP-2 and IGFBP-7 biomarker levels were assessed using the NephroCheck (bioMerieux, France) test kit at preoperative, immediate postoperative, and 24-h postoperative stages. FRV showed significantly higher immediate postoperative biomarker levels, indicating renal tubular stress. FRV patients had 21% (4/19) experiencing AKI compared to 13% (2/15) in the LFA group according to KDIGO criteria (p = 0.385). Restrictive fluid resuscitation increases the risk of AKI in surgical patients significantly, emphasizing the necessity for individualized hemodynamic management. The findings underscore the importance of urinary biomarkers in early AKI detection.
Identifiants
pubmed: 39048691
doi: 10.1038/s41598-024-68079-2
pii: 10.1038/s41598-024-68079-2
doi:
Substances chimiques
Biomarkers
0
insulin-like growth factor binding protein-related protein 1
0
Insulin-Like Growth Factor Binding Proteins
0
Tissue Inhibitor of Metalloproteinase-2
127497-59-0
TIMP2 protein, human
0
Types de publication
Journal Article
Randomized Controlled Trial
Langues
eng
Sous-ensembles de citation
IM
Pagination
17094Informations de copyright
© 2024. The Author(s).
Références
Lewington, A. J., Cerda, J. & Mehta, R. L. Raising awareness of acute kidney injury: A global perspective of a silent killer. Kidney Int. 84, 457–467 (2013).
doi: 10.1038/ki.2013.153
pubmed: 23636171
pmcid: 3758780
Bellomo, R., Kellum, J. A. & Ronco, C. Acute kidney injury. Lancet 380, 756–766 (2012).
doi: 10.1016/S0140-6736(11)61454-2
pubmed: 22617274
Raphael Weiss, M. M., Pavenstädt, H.-J. & Zarbock, A. Acute kidney injury—A frequently underestimated problem in perioperative medicine. Dtsch. Arztebl. Int. 1, 833–842 (2019).
O’Connor, M. E., Kirwan, C. J., Pearse, R. M. & Prowle, J. R. Incidence and associations of acute kidney injury after major abdominal surgery. Intens. Care Med. 42, 521–530 (2016).
doi: 10.1007/s00134-015-4157-7
Zarbock, A. et al. Epidemiology of surgery associated acute kidney injury (EPIS-AKI): A prospective international observational multi-center clinical study. Intens. Care Med. https://doi.org/10.1007/s00134-023-07169-7 (2023).
doi: 10.1007/s00134-023-07169-7
Sung, H. M. et al. Association between postoperative acute kidney injury and mortality after plastic and reconstructive surgery. Sci. Rep. 12, 20050 (2022).
doi: 10.1038/s41598-022-24564-0
pubmed: 36414767
pmcid: 9681753
Myles, P. S. et al. Restrictive versus liberal fluid therapy for major abdominal surgery. N. Engl. J. Med. 378, 2263–2274 (2018).
doi: 10.1056/NEJMoa1801601
pubmed: 29742967
Schmid, S. et al. Algorithm-guided goal-directed haemodynamic therapy does not improve renal function after major abdominal surgery compared to good standard clinical care: A prospective randomised trial. Crit Care 20, 50 (2016).
doi: 10.1186/s13054-016-1237-1
pubmed: 26951105
pmcid: 4782303
Gocze, I. et al. Biomarker-guided intervention to prevent acute kidney injury after major surgery: The prospective randomized BigpAK study. Ann. Surg. 267, 1013–1020 (2018).
doi: 10.1097/SLA.0000000000002485
pubmed: 28857811
Sun, L. Y., Wijeysundera, D. N., Tait, G. A. & Beattie, W. S. Association of intraoperative hypotension with acute kidney injury after elective noncardiac surgery. Anesthesiology 123, 515–523 (2015).
doi: 10.1097/ALN.0000000000000765
pubmed: 26181335
Karamanos, E., Walker, R., Wang, H. T. & Shah, A. R. Perioperative fluid resuscitation in free flap breast reconstruction: When is enough enough? Plast. Reconstr. Surg. Glob. Open 8, e2662 (2020).
doi: 10.1097/GOX.0000000000002662
pubmed: 32537330
pmcid: 7253255
Motakef, S., Mountziaris, P. M., Ismail, I. K., Agag, R. L. & Patel, A. Emerging paradigms in perioperative management for microsurgical free tissue transfer: Review of the literature and evidence-based guidelines. Plast. Reconstr. Surg. 135, 290–299 (2015).
doi: 10.1097/PRS.0000000000000839
pubmed: 25539313
Perrone, R. D., Madias, N. E. & Levey, A. S. Serum creatinine as an index of renal function: New insights into old concepts. Clin. Chem. 38, 1933–1953 (1992).
doi: 10.1093/clinchem/38.10.1933
pubmed: 1394976
Mårtensson, J., Martling, C.-R. & Bell, M. Novel biomarkers of acute kidney injury and failure: Clinical applicability. Br. J. Anaesth. 109, 843–850 (2012).
doi: 10.1093/bja/aes357
pubmed: 23048068
Ostermann, M. et al. Recommendations on acute kidney injury biomarkers from the acute disease quality initiative consensus conference: A consensus statement. JAMA Netw. Open 3, e2019209 (2020).
doi: 10.1001/jamanetworkopen.2020.19209
pubmed: 33021646
Joannidis, M. et al. Use of cell cycle arrest biomarkers in conjunction with classical markers of acute kidney injury. Crit. Care Med. 47, e820–e826 (2019).
doi: 10.1097/CCM.0000000000003907
pubmed: 31343478
Ostermann, M. et al. Kinetics of urinary cell cycle arrest markers for acute kidney injury following exposure to potential renal insults. Crit. Care Med. 46, 375–383 (2018).
doi: 10.1097/CCM.0000000000002847
pubmed: 29189343
pmcid: 5821475
Li, Z., Tie, H., Shi, R., Rossaint, J. & Zarbock, A. Urinary [TIMP-2]·[IGFBP7]-guided implementation of the KDIGO bundle to prevent acute kidney injury: A meta-analysis. Br. J. Anaesth. 128, e24–e26 (2022).
doi: 10.1016/j.bja.2021.10.015
pubmed: 34794767
Obata, Y., Kamijo-Ikemori, A., Shimmi, S. & Inoue, S. Clinical usefulness of urinary biomarkers for early prediction of acute kidney injury in patients undergoing transaortic valve implantation. Sci. Rep. 13, 18569 (2023).
doi: 10.1038/s41598-023-46015-0
pubmed: 37903844
pmcid: 10616062
Anker, A. M. et al. Assessment of DIEP flap perfusion with intraoperative indocyanine green fluorescence imaging in vasopressor-dominated hemodynamic support versus liberal fluid administration: A randomized controlled trial with breast cancer patients. Ann. Surg. Oncol. 27, 399–406 (2020).
doi: 10.1245/s10434-019-07758-1
pubmed: 31468214
Anker, A. M. et al. Clinical impact of DIEP flap perforator characteristics—A prospective indocyanine green fluorescence imaging study. J. Plast. Reconstr. Aesthetic Surg. 73, 1526–1533 (2020).
doi: 10.1016/j.bjps.2020.01.019
Anker, A. M. et al. Vasopressor support vs liberal fluid administration in deep inferior epigastric perforator (DIEP) free flap breast reconstruction—A randomized controlled trial. Clin. Hemorheol. Microcirc. 69, 37–44 (2018).
doi: 10.3233/CH-189129
pubmed: 29660924
Pajenda, S. et al. NephroCheck data compared to serum creatinine in various clinical settings. BMC Nephrol. 16, 206 (2015).
doi: 10.1186/s12882-015-0203-5
pubmed: 26651477
pmcid: 4674950
Khwaja, A. KDIGO clinical practice guidelines for acute kidney injury. Nephron Clin. Pract. 120, c179–c184 (2012).
doi: 10.1159/000339789
pubmed: 22890468
Ciolino, J. D., Kaizer, A. M. & Bonner, L. B. Guidance on interim analysis methods in clinical trials. J. Clin. Transl. Sci. 7, e124 (2023).
doi: 10.1017/cts.2023.552
pubmed: 37313374
pmcid: 10260346
Lu, F. et al. Efficacy and safety of platinum-based chemotherapy as first-line therapy for metastatic triple-negative breast cancer: A meta-analysis of randomized controlled trials. Technol. Cancer Res. Treat. 20, 15330338211016368 (2021).
doi: 10.1177/15330338211016369
pubmed: 33977814
pmcid: 8120541
McSweeney, K. R. et al. Mechanisms of cisplatin-induced acute kidney injury: Pathological mechanisms, pharmacological interventions, and genetic mitigations. Cancers 13, 1572 (2021).
doi: 10.3390/cancers13071572
pubmed: 33805488
pmcid: 8036620
Anker, A. M., Prantl, L. & Klein, S. M. ASO author reflections: The silent force behind microsurgery. Ann. Surg. Oncol. 27, 407–408 (2020).
doi: 10.1245/s10434-019-08001-7
pubmed: 31667724
Kashani, K. et al. Discovery and validation of cell cycle arrest biomarkers in human acute kidney injury. Crit. Care Lond. Engl. 17, R25 (2013).
doi: 10.1186/cc12503
Husain-Syed, F. et al. Persistent decrease of renal functional reserve in patients after cardiac surgery-associated acute kidney injury despite clinical recovery. Nephrol. Dial. Transplant. 34, 308–317 (2019).
doi: 10.1093/ndt/gfy227
pubmed: 30053231
Siew, E. D., Ware, L. B. & Ikizler, T. A. Biological markers of acute kidney injury. J. Am. Soc. Nephrol. 22, 810–820 (2011).
doi: 10.1681/ASN.2010080796
pubmed: 21493774
Ronco, C., Bellomo, R. & Kellum, J. A. Acute kidney injury. The Lancet 394, 1949–1964 (2019).
doi: 10.1016/S0140-6736(19)32563-2
Ronco, C., Kellum, J. A. & Haase, M. Subclinical AKI is still AKI. Crit. Care Lond. Engl. 16, 313 (2012).
doi: 10.1186/cc11240
Gocze, I. et al. Urinary biomarkers TIMP-2 and IGFBP7 early predict acute kidney injury after major surgery. PLoS ONE 10, e0120863 (2015).
doi: 10.1371/journal.pone.0120863
pubmed: 25798585
pmcid: 4370650
Meersch, M. et al. Prevention of cardiac surgery-associated AKI by implementing the KDIGO guidelines in high risk patients identified by biomarkers: The PrevAKI randomized controlled trial. Intens. Care Med 43, 1551–1561 (2017).
doi: 10.1007/s00134-016-4670-3
Jufar, A. H. et al. Renal functional reserve: From physiological phenomenon to clinical biomarker and beyond. Am. J. Physiol. Regul. Integr. Comp. Physiol. 319, R690–R702 (2020).
doi: 10.1152/ajpregu.00237.2020
pubmed: 33074016
Fawcett, W. J. & Thomas, M. Pre-operative fasting in adults and children: Clinical practice and guidelines. Anaesthesia 74, 83–88 (2019).
doi: 10.1111/anae.14500
pubmed: 30500064