Effects on renal function of a continuous infusion of nifedipine during cardiopulmonary bypass

Bertolissi, M; Antonucci, Francesco; Monte, Amato De; Padovani, R.; Giordano, Francesco

doi:10.1016/s1053-0770(96)80245-x

Cited by 18 publications

(6 citation statements)

References 13 publications

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“…19 Using these markers of renal function and integrity, we studied the influence of dopamine and diltiazem in patients undergoing cardiac surgery. The study drugs differed from other studies 9,10,12 and were started after arrival in the intensive care unit (ICU), not during surgery, as we wanted to avoid interference with the surgical procedure.…”

mentioning

confidence: 99%

RETRACTED ARTICLE: Diltiazem may preserve renal tubular integrity after cardiac surgery

Piper

Kumle

Maleck

et al. 2003

Can J Anesth/J Can Anesth

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P Pu ur rp po os se e: : To evaluate the influence of dopamine and diltiazem on renal function and markers for acute renal failure, including urinary alpha-glutathion s-transferase (α-GST), alpha-1-microglobulin (α 1 -MG) and N-acetyl-ß-glucosaminidase (ß-NAG) after extracorporeal circulation.M Me et th ho od ds s: : In a randomized, placebo-controlled, double-blind trial we evaluated the efficacy of dopamine (2.5 µg·kg -1 ·min -1 ), diltiazem (2 µg·kg -1 ·min -1 ) or placebo administered over 48 hr postoperatively to maintain renal tubular integrity in 60 elective cardiac surgery patients. α-GST, α 1 -MG, ß-NAG, and creatinine clearance were measured from urine collected during surgery (T0), the first four hours (T1), 24 hr (T2) and 48 hr (T3) postoperatively.R Re es su ul lt ts s: : Cumulative urine output in the diltiazem group (9.0 ± 2.8 L) increased significantly compared with placebo (7.0 ± 1.6 L), but not compared with dopamine (7.8 ± 1.8 L). Creatinine clearance showed no significant intergroup differences. In all groups α 1 -MG increased from T0 to T3, but we found no significant intergroup differences. α-GST increased significantly from T0 to T3 in the placebo (2.1 ± 1.8 to 11.4 ± 8.6 µg·L -1 ) and in the dopamine groups (2.7 ± 1.8 to 13.6 ± 14.9 µg·L -1 ), but not in the diltiazem group (1.8 ± 1.4 to 3.2 ± 3.2 µg·L -1 ). Forty-eight hours postoperatively α-GST was significantly lower in the diltiazem group than in both other groups.C Co on nc cl lu us si io on ns s: : Diltiazem stimulates urine output, reduces excretion of α-GST and ß-NAG and may be useful to maintain tubular integrity after cardiac surgery. Objectif : Évaluer l'influence de la dopamine et du diltiazem sur la fonction rénale et les paramètres de l`insuffisance rénale aiguë, y compris l'alpha-glutathion S-transférase (α -GST), l'alpha-microglobuline (α 1 -MG) et la N-acétyl-ß glucosaminidase (ß-NAG) urinaires après circulation extracorporelle. Méthode : Soixante patients opérés pour un pontage aortocoronarien ont participé à un essai randomisé en double aveugle et contrôlé contre placebo pour mesurer l'efficacité de la dopamine (2,5 µg kg -1 min -1 ), du diltiazem (2 µg kg -1 min -1 ) ou d'un placebo administrés pendant 48 h postopératoires pour maintenir l'intégrité tubulaire rénale. L' α-GST, l' α 1 -MG et la ß-NAG et la clairance de la créatinine ont été mesurés dans l'urine recueillie pendant l'intervention chirurgicale (T0), quatre heures (T1), 24 h (T2) et 48 h (T3) après l'opération.Résultats : L'excrétion urinaire cumulative a augmenté significativement dans le groupe diltiazem (9,0 ± 2,8 L) comparé au groupe placebo (7,0 ± 1,6 L) mais ne différait pas dans le groupe dopamine (7,8 ± 1,8 L). Il n'y avait pas de différence significative intergroupe concernant la clairance de la créatinine. Tous les groupes montraient une augmentation d' α 1 -MG de T0 à T3, sans aucune différence significative entre les groupes. L' α-GST a augmenté de manière significative de T0 à T3 dans les groupes placebo (2,1 ± 1,8 à 11,4 ± 8,6 µg L -1 ) et d...

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mentioning

confidence: 99%

RETRACTED ARTICLE: Diltiazem may preserve renal tubular integrity after cardiac surgery

Piper

Kumle

Maleck

et al. 2003

Can J Anesth/J Can Anesth

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“…The patients that developed ARL in group G4 was 46.66%, compared to G1 of 12.5%, G2 of 37.93% and G3 of 23.53%, reinforcing the hypothesis that nifedipine may reduce the occurrence of ARL in the postoperative of patients submitted to cardiac surgery with CPB when compared to the work performed by Bertolissi et al [21].…”

Section: Resultssupporting

confidence: 72%

“…Bertolissi et al [21] evaluated the effects of the continuous administration of nifedipine over the renal function during the CPB procedure. They observed that the continuous infusion of nifedipine during the CPB reduced the occurrence of ARL and pointed out that this may consist in an extra tool for the protection of the renal function in patients submitted to cardiac surgery with CPB, decreasing the influx of calcium in the slow conduits and producing vasodilatation of the arteries.…”

Section: Resultsmentioning

confidence: 99%

Uso de nifedipina e incidência de lesão renal aguda em pós-operatório de cirurgia de revascularização do miocárdio com CEC

Passaroni¹,

Silva²,

Martins³

et al. 2010

Rev Bras Cir Cardiovasc

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Uso de nifedipina e incidência de lesão renal aguda em pós-operatório de cirurgia de revascularização do miocárdio com CECUse of nifedipine and acute kidney injury incidences in postoperative of myocardial revascularization surgery with cardiopulmonary bypass Abstract Objective: The objective of this work was to evaluate the influence of the use of nifedipine on the outcome of renal function in patients undergoing myocardial revascularization with cardiopulmonary bypass.Methods: The casuistics and variables related to cardiopulmonary bypass were studied. Serum creatinine levels were measured preoperatively, 24, 48 hours and on 7th day postoperatively. Renal failure was defined as an increase in 30% of serum creatinine levels at 24 or 48 hours postoperatively compared to those at baseline. Patients were assigned to four groups: G1 (patients who received nifedipine preoperatively); G2 (patients who received nifedipine postoperatively); G3 (patients who received nifedipine pre and postoperatively) and G4 (patients who did not receive nifedipine).Results: The mean serum creatinine levels postoperatively presented greater rise in G4 (G4>G1=G2=G3), and G4 also presented a higher percentage of patients with acute renal failure (G4>G1 and G4>G3, P<0.05; G1=G3 and G2=G4, P>0.05).Conclusion: The evaluation of serum creatinine values and incidence of acute kidney injury postoperatively suggest a possible nefro-potective effect of nifedipine in patients undergoing myocardial revascularization with cardiopulmonary bypass.Descriptors: Cardiopulmonary bypass. Acute renal Insufficiency. Myocardial revascularization. Resumo Objetivo: Avaliar durante o período perioperatório o uso da nifedipina na incidência de lesão renal aguda dos pacientes submetidos à revascularização do miocárdio com circulação extracorpórea.Métodos: Foram estudados, de modo prospectivo e sequencial, 94 pacientes submetidos à revascularização do miocárdio com circulação extracorpórea. As dosagens da creatinina sérica foram realizadas durante pré-operatório e pós-operatório de 24, 48 horas e no 7º dia. Estabeleceu-se como definição para presença de lesão renal a elevação da creatinina sérica 30% em relação ao seu valor basal nas primeiras 24 ou 48 horas de pós-operatório. Os pacientes foram divididos em quatro grupos: G1, que recebeu nifedipina no pré-operatório; G2, que recebeu nifedipina no pós-operatório; G3, que recebeu nifedipina no pré e pós-operatórios e, G4, que não recebeu nifedipina.Resultados: O grupo G4 mostrou maior elevação do percentual de creatinina sérica e maior percentual de pacientes que apresentaram insuficiência renal aguda em relação aos demais grupos no pós-operatório.Conclusão: Os valores da creatinina sérica e a incidência de lesão renal aguda no pós-operatório sugerem possível efeito nefroprotetor da nifedipina em pacientes submetidos à revascularização do miocárdio com circulação extracorpórea.Descritores: Circulação extracorpórea. Insuficiência renal aguda. Revascularização miocárdica.

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“…Nifedipine, α 2 -adrenergic agonists, prostaglandin E 1 , fenoldopam, diltiazem, pentoxifylline, phosphodiesterase III inhibitor, β-blocker, N -acetylcysteine, natriuretic peptides, and sodium nitroprusside are some examples of these experimental interventions [16, 17,19,20,21,25,26,27,28,29,30,31,32,33]. However, discordant results among studies have result from the differences in the populations being studied, the intervention applied, and the outcome measured.…”

Section: Discussionmentioning

confidence: 99%

Prevention of Acute Kidney Injury by Erythropoietin in Patients Undergoing Coronary Artery Bypass Grafting: A Pilot Study

Song

Lee²,

You³

et al. 2009

Am J Nephrol

128

137

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Background/Aims: Depending on the specific definition, acute kidney injury (AKI) occurs in 7–40% of patients undergoing cardiac surgery. Even small changes in serum creatinine (SCr) levels are associated with increased mortality after cardiac surgery. However, there are no current methods for preventing AKI after cardiac surgery. Erythropoietin (EPO) has been shown to elicit tissue-protective effects in various experimental models. In this pilot trial, we evaluated the effectiveness of EPO in the prevention of AKI after coronary artery bypass grafting (CABG). Methods: 71 patients scheduled for elective CABG randomly received either 300 U/kg of EPO or saline intravenously before surgery. AKI was defined as a 50% increase in SCr levels over baseline within the first 5 postoperative days. Estimated glomerular filtration rate (eGFR) was calculated from the Cockcroft-Gault equation. Results: Of 71 patients, 13 developed postoperative AKI: 3 of the 36 patients in the EPO group (8%) and 10 of the 35 patients in the placebo group (29%; p = 0.035). The increase in postoperative SCr concentration and the decline in postoperative eGFR were significantly lower in the EPO group than in the placebo group. Conclusions: In our small, pilot trial, prophylactic administration of EPO prevents AKI and improves postoperative renal function. These data are preliminary and require confirmation in a larger clinical trial.

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Effects on renal function of a continuous infusion of nifedipine during cardiopulmonary bypass

Cited by 18 publications

References 13 publications

RETRACTED ARTICLE: Diltiazem may preserve renal tubular integrity after cardiac surgery

RETRACTED ARTICLE: Diltiazem may preserve renal tubular integrity after cardiac surgery

Uso de nifedipina e incidência de lesão renal aguda em pós-operatório de cirurgia de revascularização do miocárdio com CEC

Prevention of Acute Kidney Injury by Erythropoietin in Patients Undergoing Coronary Artery Bypass Grafting: A Pilot Study

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