The Efficacy of Oral Melatonin in Abdominal Aortic Aneurysm Surgery

Renal ischemia–reperfusion injury (IRI) is a significant complication in abdominal aortic aneurysm (AAA) surgery, contributing to morbidity and mortality. Melatonin, with antioxidant and anti-inflammatory properties, has shown promise in preclinical studies, but clinical data remain limited. To evaluate the safety and efficacy of oral melatonin supplementation in preventing renal IRI in patients undergoing AAA surgery. This randomized controlled study evaluated the effect of oral melatonin on renal IRI in 18 patients undergoing AAA surgery at Maharaj Nakorn Chiang Mai Hospital. Patients were randomly assigned to receive 10 mg of oral melatonin (n = 9) or placebo (n = 9) nightly for 3 days pre- and post-surgery. The primary outcome was the incidence of acute kidney injury (AKI). Secondary outcomes included urine output, serum biomarkers, and oxidative stress parameters. No patients in the melatonin group developed postoperative AKI, while two cases were reported in the control group. The melatonin group tended to have higher urine output at 24 and 48 hours postoperatively, but the difference was not statistically significant, with no adverse events linked to melatonin. However, no significant differences were observed in serum biomarkers, including neutrophil gelatinase-associated lipocalin (NGAL), or in oxidative and inflammatory markers between the groups. Oral melatonin was safe and well-tolerated in patients undergoing AAA surgery. Although it showed potential in reducing AKI incidence and improving urine output, it did not significantly impact oxidative or inflammatory markers. Larger studies are needed to validate the renal protective effects of melatonin in AAA surgery.