Key result
Ivabradine significantly improved eGFR by Cystatin C (103.32 vs 96.25; P<0.001) and reduced heart rate in septic patients with early renal impairment.
Why the study?
Lower heart rate is associated with better survival in multiple organ dysfunction syndrome, but whether using ivabradine to reduce heart rate improves renal function in septic patients with renal impairment was unknown.
Does ivabradine improve renal function and reduce heart rate in septic patients with early renal impairment?
RCT (n=50)
1:1 ratio
Does ivabradine improve renal function and reduce heart rate in septic patients with early renal impairment?
In septic patients with early renal impairment, ivabradine significantly reduced heart rate and improved eGFR, though it did not significantly affect mortality or length of stay.
May support adjunctive renal preservation in early septic impairment; hypothesis-generating and requires larger randomized confirmation before practice change.
Background Acute kidney injury (AKI) with sepsis increases mortality significantly. The pathophysiology of AKI during sepsis is complex and multifactorial. Lower heart rate is associated with better survival in patients with multiple organ dysfunction syndrome (MODS), a disease mostly caused by sepsis. In our study, we hypnotized that use of ivardrabine as heart rate reducing agent in septic patient with renal impairment may improve renal function. Results Fifty patients with sepsis with early renal impairment were divided in 1: 1 ratio to receive Ivabradine (group I) or not (group C). The average age of the included patients was almost 45 years, chest disorders were the main cause of sepsis in both groups. There were statistically significant differences between both groups in terms of reduction of heart rate group (I) (68.13 ± 3.34) versus (group C) (87.04 ± 3.23) and (P < 0.001) also, improvement in eGFR by Cystatin c in group (I) (103.32 ± 6.96) versus (group C) (96.25 ± 6.36) and (P < 0.001) also vasopressor dosage consumption (P < 0.001). As regards secondary outcomes, there were no statistically significant differences between study’s groups in terms of length of hospital stay (P = 0.390), need for hemodialysis (P = 0.384), and mortality (P = 1.000). Conclusions We concluded that Ivabradine as an adjuvant therapy in septic patients with renal impairment is promising agent to reduce such impairment. Trial registration Pan African Clinical Trial Registry: Identification number for the registry is PACTR201911806644230 .
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Sobhy et al. (2021) conducted an RCT in Sepsis with early renal impairment (n=50). Ivabradine vs. No ivabradine was evaluated on eGFR by Cystatin c (p=< 0.001). Ivabradine significantly improved eGFR by Cystatin C (103.32 vs 96.25; P<0.001) and reduced heart rate in septic patients with early renal impairment.
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