N-acetylcysteine versus dopamine to prevent acute kidney injury after cardiac surgery in patients with preexisting moderate renal insufficiency
Rev. bras. cir. cardiovasc; 32 (1), 2017
Publication year: 2017
Abstract 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.
Acetilcisteína/administración & dosificación, Lesión Renal Aguda/tratamiento farmacológico, Lesión Renal Aguda/etiología, Lesión Renal Aguda/prevención & control, Procedimientos Quirúrgicos Cardíacos/efectos adversos, Puente Cardiopulmonar, Puente de Arteria Coronaria, Dopamina/administración & dosificación, Método Doble Ciego, Placebos, Complicaciones Posoperatorias, Insuficiencia Renal