55
Views
37
CrossRef citations to date
0
Altmetric
Brief Report

Renal protection by radical scavenging in cardiac surgery patients

, &
Pages 1161-1164 | Accepted 27 May 2005, Published online: 22 Jun 2005
 

ABSTRACT

Objective: Renal function impairment is a common complication in cardiac surgery patients. Because cardiopulmonary bypass and cardioplegic arrest are associated with formation of free radicals, which have been shown to impair various organs including the kidneys, radical scavenging may protect renal function. Therefore, the purpose of our study was to evaluate the impact of the radical scavenger N-acetylcysteine (NAC) versus placebo on peri-operative renal function in cardiac surgery patients.

Research design and methods: We reanalyzed the data of our previous study in which 40 coronary artery surgery patients (66 ± 9 [SD] years, 9 women and 31 men) with normal pre-operative renal function had been randomized in a double-blind fashion to receive either NAC (100 mg/kg into the cardiopulmonary bypass prime followed by infusion at 20 mg/kg/h; n = 20) or placebo (n = 20). We determined serum creatinine levels as an indicator for renal function pre- and at 1 day post-surgery as well as peri-operative urinary output and diuretic medication. Creatinine clearance was calculated according to Cockcroft and Gault.

Results: Biometric and intra-operative patient data were similar between both groups. In the placebo group, serum creatinine increased from 93.1 ± 35.4 µmol/L pre-operatively to 115.9 ± 47.2 µmol/L on post-op day 1 ( p < 0.001). In contrast, serum creatinine in the NAC group remained unchanged (92.3 ± 31.3 µmol/L pre-op; 99.3 ± 25.4 µmol/L on post-op day 1; p = 0.084). Accordingly, creatinine clearance decreased by 16.9 ± 14.3 mL/min in the placebo group as compared to 7.5 ± 17.7 mL/min in the NAC group ( p = 0.039). Urinary output and diuretic medication were similar between NAC and placebo.

Conclusions: Our data suggest that free radical-scavenging using NAC protects renal function in patients subjected to cardiac surgery on cardiopulmonary bypass.

Reprints and Corporate Permissions

Please note: Selecting permissions does not provide access to the full text of the article, please see our help page How do I view content?

To request a reprint or corporate permissions for this article, please click on the relevant link below:

Academic Permissions

Please note: Selecting permissions does not provide access to the full text of the article, please see our help page How do I view content?

Obtain permissions instantly via Rightslink by clicking on the button below:

If you are unable to obtain permissions via Rightslink, please complete and submit this Permissions form. For more information, please visit our Permissions help page.