Background: Several studies have shown that sodium-glucose cotransporter-2 inhibitors have a renoprotective effect on acute kidney injury (AKI), but their effect on cardiac surgery-associated AKI is unknown.
Methods And Results: AKI was induced in 25 rabbits without diabetes mellitus by cardiopulmonary bypass (CPB) for 2 h and they were divided into 5 groups: sham; dapagliflozin-treated sham; CPB; dapagliflozin-treated CPB; and furosemide-treated CPB (n=5 in each group). Dapagliflozin was administered via the femoral vein before initiating CPB. Kidney tissue and urine and blood samples were collected after the surgical procedure. There were no differences in the hemodynamic variables of each group. Dapagliflozin reduced serum creatinine and blood urea nitrogen concentrations, and increased overall urine output (all P<0.05). Hematoxylin and eosin staining showed that the tubular injury score was improved after dapagliflozin administration (P<0.01). Dapagliflozin administration mitigated reactive oxygen species and kidney injury molecule-1 as assessed by immunohistochemistry (both P<0.0001). Protein expression analysis showed improvement of inflammatory cytokines and apoptosis, and antioxidant enzyme expression was elevated (all P<0.05) through activation of the nuclear factor erythroid 2-related factor 2 pathway (P<0.01) by dapagliflozin.
Conclusions: Acute intravenous administration of dapagliflozin protects against CPB-induced AKI. Dapagliflozin may have direct renoprotective effects in renal tubular cells.
Objective: This study was designed to investigate the distribution of nadir oxygen delivery (DO), mean DO, and area under ideal DO (AUiDO) among categorized age groups of pediatric patients and their associations with postoperative cardiac surgery-associated (CSA) acute kidney injury (AKI) and clinical outcomes.
Background: Cardiac surgery-associated acute kidney injury (CSA-AKI) is a common complication of cardiac surgery and is associated with increased morbidity and mortality. Recent guidelines emphasize the need for new monitoring methods to facilitate targeted CSA-AKI prevention and treatment strategies. In vivo real-time measurement of mitochondrial oxygen tension (mitoPO), could potentially fulfil this role during cardiac surgery, as suggested in our previous pilot study.
Department of Critical Care, The University of Melbourne, Melbourne, Australia; Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, Australia; Data Analytics Research and Evaluation Centre, Austin Hospital, Melbourne, Australia; Department of Intensive Care, Austin Hospital, Melbourne, Australia; Centre for Clinical Informatics, Royal Melbourne Hospital, Melbourne, Australia; Department of Intensive Care, Royal Melbourne Hospital, Melbourne, Australia. Electronic address:
Background: Acute kidney injury (AKI) is a frequent and important complication of cardiac surgery. Decreased perfusion is a key mechanism. Such decreased perfusion may be attenuated by intravenous amino acids (AA) through recruitment of renal functional reserve.
Introduction: Cardiac surgery-associated acute kidney injury (CSA-AKI) is a well-known complication that increases morbidity and mortality rates. The objective of this study was to reduce CSA-AKI through nephrologist intervention in patients awaiting cardiac surgery.
Methods: We performed a single center, open-label, randomized clinical trial including 380 patients who underwent scheduled cardiac surgery at the Hospital de Bellvitge between July 2015 and October 2019.
