Mannitol and Renal Dysfunction After Endovascular Aortic Aneurysm Repair Procedures: A Randomized Trial

Kalimeris, Konstantinos; Nikolakopoulos, Nikolaos; Riga, Maria; Christodoulaki, Kalliopi; Moulakakis, Konstantinos G.; Dima, Cleanthi; Papasideris, Christos; Sidiropoulou, Tatiana; Kostopanagiotou, Georgia; Pandazi, Ageliki

doi:10.1053/j.jvca.2013.08.009

Cited by 20 publications

(10 citation statements)

References 31 publications

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“…When mannitol is inhaled, it helps in mucus and cough clearance in asthmatics and other hypersecretory diseases [81,82]. Mannitol accompanied with hydration during endovascular aortic aneurysm repair might improve renal function [83].…”

Section: Properties and Applicationsmentioning

confidence: 99%

Sugar alcohols—their role in the modern world of sweeteners: a review

Grembecka

2015

Eur Food Res Technol

321

296

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observed. It was mainly due to the developments in biological studies, the change of a population lifestyle and the increase in the consumer awareness concerning food products. The health quality of food depends mainly on nutrients, but also on foreign substances such as food additives. The presence of foreign substances in the food can be justified, allowed or tolerated only when they are harmless to our health. Epidemic obesity and diabetes encouraged the growth of the artificial sweetener industry. There are more and more people who are trying to lose weight or keeping the weight off; therefore, sweeteners can be now found in almost all food products. There are two main types of sweeteners, i.e., nutritive and artificial ones. The latter does not provide calories and will not influence blood glucose; however, some of nutritive sweeteners such as sugar alcohols also characterize with lower blood glucose response and can be metabolized without insulin, being at the same time natural compounds. Sugar alcohols (polyols or polyhydric alcohols) are low digestible carbohydrates, which are obtained by substituting and aldehyde group with a hydroxyl one [1,2]. As most of sugar alcohols are produced from their corresponding aldose sugars, they are also called alditols [3]. Among sugar alcohols can be listed hydrogenated monosaccharides (sorbitol, mannitol), hydrogenated disaccharides (isomalt, maltitol, lactitol) and mixtures of hydrogenated mono-diand/or oligosaccharides (hydrogenated starch hydrolysates) [1,2,4].Polyols are naturally present in smaller quantities in fruits as well as in certain kinds of vegetables or mushrooms, and they are also regulated as either generally recognized as safe or food additives [5][6][7]. Food additives are substances that are added intentionally to foodstuffs in order to perform certain technological functions such as to give color, to sweeten or to help in food preservation.Abstract Epidemic obesity and diabetes encouraged the changes in population lifestyle and consumers' food products awareness. Food industry has responded people's demand by producing a number of energy-reduced products with sugar alcohols as sweeteners. These compounds are usually produced by a catalytic hydrogenation of carbohydrates, but they can be also found in nature in fruits, vegetables or mushrooms as well as in human organism. Due to their properties, sugar alcohols are widely used in food, beverage, confectionery and pharmaceutical industries throughout the world. They have found use as bulk sweeteners that promote dental health and exert prebiotic effect. They are added to foods as alternative sweeteners what might be helpful in the control of calories intake. Consumption of low-calorie foods by the worldwide population has dramatically increased, as well as health concerns associated with the consequent high intake of sweeteners. This review deals with the role of commonly used sugar alcohols such as erythritol, isomalt, lactitol, maltitol, mannitol, sorbitol and xylitol as sugar substitutes in food ...

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Section: Properties and Applicationsmentioning

confidence: 99%

Sugar alcohols—their role in the modern world of sweeteners: a review

Grembecka

2015

Eur Food Res Technol

321

296

View full text Add to dashboard Cite

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“…[ 39 , 40 ] Furthermore, another study suggested that mannitol administration plus hydration offers a significant protection against renal function estimated by serum creatinine and cystatin-C 24 hours after endovascular aortic aneurysm repair compared to hydration alone. [ 41 ] In that study, it was found that mannitol stimulates prostaglandin-I 2 synthesis, increases renal blood flow, and reverses established renal vasoconstriction during endovascular aortic aneurysm repair. However, these protective effects were not maintained at 72 hours because renal dysfunction also is induced by various mechanisms, including renal microembolization and bilateral renal artery stenosis after the procedure.…”

Section: Discussionmentioning

confidence: 99%

Effect of intraoperative mannitol administration on acute kidney injury after robot-assisted laparoscopic radical prostatectomy

Kong

Park²,

Park³

et al. 2018

Medicine

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Mannitol, an osmotic diuretic, has been used to prevent acute kidney injury (AKI). However, studies have found divergent effects of intraoperative mannitol administration on postoperative AKI. We therefore evaluated the effects of intraoperative mannitol administration on AKI after robot-assisted laparoscopic radical prostatectomy (RALP) in prostate cancer patients.A total of 864 patients who underwent RALP were divided into mannitol (administered at 0.5 g/kg) and no-mannitol groups. Demographics, cancer-related data, preoperative laboratory values, intraoperative data, and postoperative outcomes such as AKI, chronic kidney disease at 12 months postoperation, duration of hospital stay, and intensive care unit admission rate and duration of stay were compared between the 2 groups using propensity score matching analysis. To determine the risk factors for AKI after RALP, univariate and multivariate logistic regression analyses were performed. Postoperative AKI was defined according to the Kidney Disease: Improving Global Outcomes criteria.After performing 1:1 propensity score matching, the mannitol and no-mannitol groups included 234 patients each. The overall incidence of AKI after RALP was 5.1% and was not significantly different between the no-mannitol and mannitol groups in the propensity score-matched patients (13 [5.6%] vs. 11 [4.7%], P = .832). Univariate logistic regression analysis revealed that body mass index and operative time were associated with AKI in 864 patients who underwent RALP. However, intraoperative mannitol administration was not associated with AKI after RALP (P = .284). Multivariate logistic regression analysis revealed that operative time was significantly associated with AKI after RALP (odds ratio = 1.013, P = .001). The incidence of chronic kidney disease (13 [5.6%] vs. 12 [5.1%], P = 1.000) and other postoperative outcomes were not also significantly different between the no-mannitol and mannitol groups in the propensity score-matched patients.Intraoperative mannitol administration has no beneficial effect on the prevention of AKI after RALP in prostate cancer patients. This result provides useful information for clinical practice guidelines regarding intraoperative mannitol use.

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“…In a meta-analysis by Yang et al, mannitol did not demonstrate evident effectiveness for the prevention of AKI [ 185 ]. In subsequent RCTs, the mannitol groups also failed to demonstrate significant improvement in their RRT initiation rates or in-hospital mortality [ 186 , 187 ].…”

Section: Commentarymentioning

confidence: 99%

The Japanese clinical practice guideline for acute kidney injury 2016

et al. 2018

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Acute kidney injury (AKI) is a syndrome which has a broad range of etiologic factors depending on different clinical settings. Because AKI has significant impacts on prognosis in any clinical settings, early detection and intervention is necessary to improve the outcomes of AKI patients. This clinical guideline for AKI was developed by a multidisciplinary approach with nephrology, intensive care medicine, blood purification, and pediatrics. Of note, clinical practice for AKI management which was widely performed in Japan was also evaluated with comprehensive literature search.

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Mannitol and Renal Dysfunction After Endovascular Aortic Aneurysm Repair Procedures: A Randomized Trial

Cited by 20 publications

References 31 publications

Sugar alcohols—their role in the modern world of sweeteners: a review

Sugar alcohols—their role in the modern world of sweeteners: a review

Effect of intraoperative mannitol administration on acute kidney injury after robot-assisted laparoscopic radical prostatectomy

The Japanese clinical practice guideline for acute kidney injury 2016

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