Intravenous Amino Acid Infusion Reduces Acute Kidney Injury Risk in Cardiac Surgery Patients With Cardiopulmonary Bypass
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Reviewed & Translated by Dat Tien Nguyen, B.A, ScM.
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Posted on October 9th, 2024
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Renal hypoperfusion during cardiopulmonary bypass surgery can reduce the glomerular filtration rate, leading to acute kidney injury, which is linked to high morbidity and a significantly increased risk of chronic kidney disease and mortality. Previous studies have demonstrated that amino acid infusion may mitigate renal hypoperfusion and improve renal oxygenation. In light of this, the Italian Ministry of Health funded a study to explore the potential benefits of intravenous amino acid infusion during cardiac surgery.
The clinical study involved 3,511 patients scheduled for cardiac surgery with cardiopulmonary bypass. The baseline serum creatinine level of the cohort was approximately 0.95 mg/dL, which was used as a reference to assess post-surgery acute kidney injury (AKI). Participants were randomly assigned to receive either a placebo (Ringer’s solution) or a mixture containing a daily dose of 2 g of amino acids per kilogram of body weight. The therapy was administered over three days prior to surgery, with patient health monitored for seven days post-surgery. Results showed that intravenous amino acid infusion reduced the risk of acute kidney injury by 15%. Additionally, the treatment lowered the risk of severe stage 3 AKI, defined as a tripling of baseline serum creatinine levels, by 44%. The researchers attributed the renal protection to increased renal medullary perfusion and enhanced glomerular blood flow caused by the amino acid infusion. Moreover, it has been shown that a high-protein diet may stimulate endothelial growth factor, promoting an increase in glomerular diameter and filtration rate.
The clinical study involved 3,511 patients scheduled for cardiac surgery with cardiopulmonary bypass. The baseline serum creatinine level of the cohort was approximately 0.95 mg/dL, which was used as a reference to assess post-surgery acute kidney injury (AKI). Participants were randomly assigned to receive either a placebo (Ringer’s solution) or a mixture containing a daily dose of 2 g of amino acids per kilogram of body weight. The therapy was administered over three days prior to surgery, with patient health monitored for seven days post-surgery. Results showed that intravenous amino acid infusion reduced the risk of acute kidney injury by 15%. Additionally, the treatment lowered the risk of severe stage 3 AKI, defined as a tripling of baseline serum creatinine levels, by 44%. The researchers attributed the renal protection to increased renal medullary perfusion and enhanced glomerular blood flow caused by the amino acid infusion. Moreover, it has been shown that a high-protein diet may stimulate endothelial growth factor, promoting an increase in glomerular diameter and filtration rate.