Why the study?
Acute kidney injury is a common and often severe postoperative complication after cardiac surgery associated with poor outcomes, yet most prevention trials have been negative.
Do various preventive strategies reduce the incidence of acute kidney injury in patients undergoing cardiac surgery?
Do various preventive strategies reduce the incidence of acute kidney injury in patients undergoing cardiac surgery?
Current evidence for preventing cardiac surgery-associated acute kidney injury is largely negative, though a few specific interventions show promise and warrant large-scale validation.
Preoperative corticosteroids may reduce cardiac surgery-associated AKI; hypothesis-generating and requires validation in definitive RCTs.
Acute kidney injury is a common and often severe postoperative complication after cardiac surgery, and is associated with poor short-term and long-term outcomes. Numerous randomized controlled trials have been conducted to investigate various strategies for prevention of cardiac surgery-associated acute kidney injury. Unfortunately, most trials that have been conducted to date have been negative. However, encouraging results have been demonstrated with preoperative administration of corticosteroids, leukocyte filtration, and administration of inhaled nitric oxide intraoperatively, and implementation of a Kidney Disease: Improving Global Outcomes bundle of care approach postoperatively. These findings require validation in large, multicenter trials.
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Jacob et al. (2019) studied this question.
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