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N-acetylcysteine versus Dopamine to Prevent AcuteKidney Injury after Cardiac Surgery in Patients with Preexisting Moderate Renal Insufficiency

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ABSTRACT

Objective: Acute kidney injury after cardiac surgery is associated with mortality andmorbidity. Therefore, strategies to prevent acute kidney injury are veryimportant. The aim of this placebo-controlled randomized double-blind studywas to compare the prophylactic efficacy of N-Acetylcysteine and dopamineadministration in patients with pre-existing moderate renal insufficiencywho were undergoing cardiopulmonary bypass.

Methods: This study included 135 patients with pre-existing moderate renalinsufficiency who were scheduled for coronary artery bypass graftingsurgery. Serum creatinine and GFR were recorded preoperatively and on thefirst and second postoperative days.

Results: On the first and second postoperative days, the drugs used showedstatistically significant differences among the creatinine groups(P<0.001). According to Tukey’s HSD, on the firstand second PO, the creatinine of Group N, D and P were significantlydifferent (P<0.001). On the first and second PO, theused drugs showed statistically significant differences among the effects ofeGFR (P<0.001). According to Tukey’s HSD on the firstpostoperative day, the average eGFR score of Group N compared to D and Pwere significantly difference (P<0.001). On the secondpostoperative 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 aprotective effect on renal function, whereas the application of renal dosedopamine did not have a protective effect in patients with pre-existingmoderate renal failure.

No MeSH data available.


Evolution of eGFR from first postoperative day to second postoperativeday in NAC, Dopamine and Placebo Groups.
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f1: Evolution of eGFR from first postoperative day to second postoperativeday in NAC, Dopamine and Placebo Groups.

Mentions: Preoperative eGFR showed no statistically significant differences among Groups N, D,and P (P=0.43). In the first and second postoperative periods, theused drugs showed statistically significant differences in terms of the effects ofeGFR (P<0.001; Table 3).A post hoc test was performed for comparison to determine thesource of this difference between the groups. According to Tukey’s HSD multiplecomparison test results, in the first postoperative period, the average eGFR scoreof Group N compared to Group D and Group P was significantly different(P<0.001; Table 4).In the second postoperative period, the eGFR average scores of Group N and Group Dshowed no difference (P=0.37), but Group P exhibited a difference(P<0.001; Table 5).Evolution of eGFR in the three groups from the first day to the second postoperativeday is shown in Figure 1.


N-acetylcysteine versus Dopamine to Prevent AcuteKidney Injury after Cardiac Surgery in Patients with Preexisting Moderate Renal Insufficiency
Evolution of eGFR from first postoperative day to second postoperativeday in NAC, Dopamine and Placebo Groups.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5382906&req=5

f1: Evolution of eGFR from first postoperative day to second postoperativeday in NAC, Dopamine and Placebo Groups.
Mentions: Preoperative eGFR showed no statistically significant differences among Groups N, D,and P (P=0.43). In the first and second postoperative periods, theused drugs showed statistically significant differences in terms of the effects ofeGFR (P<0.001; Table 3).A post hoc test was performed for comparison to determine thesource of this difference between the groups. According to Tukey’s HSD multiplecomparison test results, in the first postoperative period, the average eGFR scoreof Group N compared to Group D and Group P was significantly different(P<0.001; Table 4).In the second postoperative period, the eGFR average scores of Group N and Group Dshowed no difference (P=0.37), but Group P exhibited a difference(P<0.001; Table 5).Evolution of eGFR in the three groups from the first day to the second postoperativeday is shown in Figure 1.

View Article: PubMed Central - PubMed

ABSTRACT

Objective: Acute kidney injury after cardiac surgery is associated with mortality andmorbidity. Therefore, strategies to prevent acute kidney injury are veryimportant. The aim of this placebo-controlled randomized double-blind studywas to compare the prophylactic efficacy of N-Acetylcysteine and dopamineadministration in patients with pre-existing moderate renal insufficiencywho were undergoing cardiopulmonary bypass.

Methods: This study included 135 patients with pre-existing moderate renalinsufficiency who were scheduled for coronary artery bypass graftingsurgery. Serum creatinine and GFR were recorded preoperatively and on thefirst and second postoperative days.

Results: On the first and second postoperative days, the drugs used showedstatistically significant differences among the creatinine groups(P&lt;0.001). According to Tukey&rsquo;s HSD, on the firstand second PO, the creatinine of Group N, D and P were significantlydifferent (P&lt;0.001). On the first and second PO, theused drugs showed statistically significant differences among the effects ofeGFR (P&lt;0.001). According to Tukey&rsquo;s HSD on the firstpostoperative day, the average eGFR score of Group N compared to D and Pwere significantly difference (P&lt;0.001). On the secondpostoperative day, the eGFR of Group N and D showed no difference(P=0.37), but P showed a difference(P&lt;0.001).

Conclusion: We found that the prophylactic use of intravenous N-Acetylcysteine had aprotective effect on renal function, whereas the application of renal dosedopamine did not have a protective effect in patients with pre-existingmoderate renal failure.

No MeSH data available.