Renal protection by radical-scavenging in cardiac surgery patients

Fischer, U.; Tossios, Paschalis; Hbner, A; Kanani, GR; Sdkamp, M; Raji, R; Vivie, ER de; Mehlhorn, Uwe

doi:10.1055/s-2004-816795

Cited by 7 publications

(14 citation statements)

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“…Fischer et al [10] showed that NAC reduced serum creatinine compared with the control group in their study. Moreover, Wijeysundera et al [11] found that there was preservation of postoperative eGFR in patients with preexisting moderate renal dysfunction undergoing cardiac surgery and a significant reduction in mortality with NAC.…”

Section: Discussionmentioning

confidence: 85%

N-acetylcysteine Versus Dopamine to Prevent Acute Kidney Injury After Cardiac Surgery In Patients with Pre-existing Moderate Renal Insufficiency

Şavluk

Güzelmeriç

Yavuz

et al. 2015

Journal of Cardiothoracic and Vascular Anesthesia

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Objective: Acute kidney injury after cardiac surgery is associated with mortality and morbidity. Therefore, strategies to prevent acute kidney injury are very important. The aim of this placebo-controlled randomized double-blind study was to compare the prophylactic efficacy of N-Acetylcysteine and dopamine administration in patients with pre-existing moderate renal insufficiency who were undergoing cardiopulmonary bypass.Methods: This study included 135 patients with pre-existing moderate renal insufficiency who were scheduled for coronary artery bypass grafting surgery. Serum creatinine and GFR were recorded preoperatively and on the first and second postoperative days.Results: On the first and second postoperative days, the drugs used showed statistically significant differences among the creatinine groups (P<0.001). According to Tukey's HSD, on the first and second PO, the creatinine of Group N, D and P were significantly different (P<0.001). On the first and second PO, the used drugs showed statistically significant differences among the effects of eGFR (P<0.001). According to Tukey's HSD on the first postoperative day, the average eGFR score of Group N compared to D and P were significantly difference (P<0.001). On the second postoperative day, the eGFR of Group N and D showed no difference (P=0.37), but P showed a difference (P<0.001).Conclusion: We found that the prophylactic use of intravenous N-Acetylcysteine had a protective effect on renal function, whereas the application of renal dose dopamine did not have a protective effect in patients with pre-existing moderate renal failure.

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Section: Discussionmentioning

confidence: 85%

N-acetylcysteine Versus Dopamine to Prevent Acute Kidney Injury After Cardiac Surgery In Patients with Pre-existing Moderate Renal Insufficiency

Şavluk

Güzelmeriç

Yavuz

et al. 2015

Journal of Cardiothoracic and Vascular Anesthesia

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“…It has been reported that 8-iso-PGF 2a is a potent vasoconstrictor in the lungs and kidneys (31), and it could increase the pulmonary artery pressure after the end of CPB, or even result in impairment of the left ventricular preload, compromising the hemodynamics of the ventricle. It is known that patients receiving CPB experience acute renal injury with an incidence of up to 30%, and it has been suggested that the cause of these complications is related to neutrophil activation, which is a major source of ROS release (32). Therefore, prescribing antioxidants before or during CPB could potentially be helpful for these patients.…”

Section: Discussionmentioning

confidence: 99%

Quantification of urinary 8‐iso‐prostaglandin F_2α using liquid chromatography–tandem mass spectrometry during cardiac valve surgery

Teng

Wang

Liao³

et al. 2010

Clinical Laboratory Analysis

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Oxidative stress is an unavoidable event during many complex surgical procedures. 8-iso-prostaglandin F(2alpha) (8-iso-PGF(2alpha)) is a reliable biomarker for the evaluation of oxidative stress in vivo. The aim of this study is to develop simple and accurate liquid chromatography-tandem mass spectrometry (LC-MS/MS) methods for the detection of urinary 8-iso-PGF(2alpha) in samples collected from patients who received a cardiopulmonary bypass (CPB) during cardiac valve surgery. Urine samples of 14 patients with cardiac valve diseases were collected before, during, and after CPB. The level of 8-iso-PGF(2alpha) was detected via selected-reaction monitoring triple quadrupole MS/MS and the result was compared with 12 healthy volunteers. The method's detection limit (3S/N) was 0.25 pg for 8-iso-PGF(2alpha), with a linear working range of 0.25-20 ng/ml. For patients with cardiac valve disease, the 8-iso-PGF(2alpha) levels before the bypasses were the same as those of healthy individuals (P>0.05) and the 8-iso-PGF(2alpha) levels during and after CPB were significantly higher than those before the bypasses (P<0.05). In conclusion, we present a simple and specific protocol for LC-MS/MS quantification of urinary 8-iso-PGF(2alpha) collected during CPB. Using this technique, it would be feasible to assess the levels of oxidative stress during cardiac surgery and thereby helpful for the management of oxidative injury.

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“…As a preventive measure, NAC is presently often used in individuals with renal impairment or cardiac surgery to protect against acute renal failure [47,50,51] . In this context -because of its antioxidative actions with a subsequent rise in NO bioavailability -NAC has been proposed as a valuable tool to improve renal perfusion [49,52] .…”

Section: Discussionmentioning

confidence: 99%

N-Acetylcysteine Attenuates Iodine Contrast Agent-Induced Nephropathy in 5/6-Nephrectomized Rats

Šochman¹,

Peregrin

Bürgelová³

et al. 2010

Kidney Blood Press Res

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Aims: In the present study we tested the efficacy of N-acetylcysteine (NAC) to minimize nephrotoxic effects of iodine contrast agents in intact rats as well as in 5/6-nephrectomized (5/6-Nx) rats. Methods: Rats were allocated to a group of intact rats (n = 42) and a group of 5/6-Nx rats (n = 42). After 1 month of recovery from surgery, 5/6-Nx rats and intact (sham-operated) animals received either 6 ml/kg body weight (b.w.) meglumine ioxithalamate (Telebrix 350) or 6 ml/kg b.w. iohexol (Omnipaque 350) intravenously with or without pretreatment with 100 mg/kg b.w. NAC. Plasma and urinary concentrations of creatinine, sodium and protein in 24-hour urine collections were determined prior to and on days 1, 3 and 7 after drug administration. Results: In intact animals, contrast agents caused no significant changes in kidney function throughout the duration of the experiment. In contrast, significant increases in plasma creatinine levels and decreases in creatinine clearance were induced by both contrast agents in 5/6-Nx rats. These changes were significantly attenuated by NAC pretreatment. Conclusion: The results of the present study demonstrate that iodine contrast agent-induced nephropathy in 5/6-Nx rats is significantly attenuated by intravenous pretreatment with NAC.

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Renal protection by radical-scavenging in cardiac surgery patients

Cited by 7 publications

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N-acetylcysteine Versus Dopamine to Prevent Acute Kidney Injury After Cardiac Surgery In Patients with Pre-existing Moderate Renal Insufficiency

N-acetylcysteine Versus Dopamine to Prevent Acute Kidney Injury After Cardiac Surgery In Patients with Pre-existing Moderate Renal Insufficiency

Quantification of urinary 8‐iso‐prostaglandin F_2α using liquid chromatography–tandem mass spectrometry during cardiac valve surgery

N-Acetylcysteine Attenuates Iodine Contrast Agent-Induced Nephropathy in 5/6-Nephrectomized Rats

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Renal protection by radical-scavenging in cardiac surgery patients

Cited by 7 publications

References 0 publications

N-acetylcysteine Versus Dopamine to Prevent Acute Kidney Injury After Cardiac Surgery In Patients with Pre-existing Moderate Renal Insufficiency

N-acetylcysteine Versus Dopamine to Prevent Acute Kidney Injury After Cardiac Surgery In Patients with Pre-existing Moderate Renal Insufficiency

Quantification of urinary 8‐iso‐prostaglandin F2α using liquid chromatography–tandem mass spectrometry during cardiac valve surgery

N-Acetylcysteine Attenuates Iodine Contrast Agent-Induced Nephropathy in 5/6-Nephrectomized Rats

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Quantification of urinary 8‐iso‐prostaglandin F_2α using liquid chromatography–tandem mass spectrometry during cardiac valve surgery