Impact of Custodiol‐N cardioplegia on acute kidney injury after cardiopulmonary bypass

Autor:	Maja-Theresa Dieterlen, Michael A. Borger, Alexandro Hoyer, Aida Salameh, Susann Oßmann, Kristin Klaeske, Nina Feirer, Philipp Kiefer
Rok vydání:	2020
Předmět:	Male 0301 basic medicine medicine.medical_specialty Time Factors Swine Physiology medicine.medical_treatment Organ Preservation Solutions Urology chemistry.chemical_element Calcium law.invention Hemoglobins 03 medical and health sciences 0302 clinical medicine law Physiology (medical) medicine Cardiopulmonary bypass Animals Pharmacology Kidney Cardiopulmonary Bypass biology business.industry Cytochrome c Acute kidney injury Cytochromes c Acute Kidney Injury medicine.disease 030104 developmental biology medicine.anatomical_structure chemistry Median sternotomy 030220 oncology & carcinogenesis Heart Arrest Induced biology.protein Hemoglobin Complication business
Zdroj:	Clinical and Experimental Pharmacology and Physiology. 47:640-649
ISSN:	1440-1681 0305-1870
DOI:	10.1111/1440-1681.13236
Popis:	Myocardial protection during cardiopulmonary bypass (CPB) can be achieved using cardioplegic solutions. Although, acute kidney injury (AKI) is a common complication following CPB, the effects of cardioplegic solutions on AKI have rarely been investigated. Within this study, the effects of the cardioplegic solutions histidine-tryptophan-ketoglutarate (HTK; Custodiol) and HTK-N (Custodiol-N) on AKI in a large animal model were compared. Therefore, Landrace pigs underwent median sternotomy, CPB at 34°C, 90 minutes of cardiac arrest and 120 minutes of reperfusion. Animals were randomized for single-shot cardioplegia with either HTK (n = 10) or HTK-N (n = 10). Renal biopsies and sera were analyzed to determine AKI biomarkers and apoptosis. Compared to HTK, HTK-N induced a decreased extent of proximal tubule swelling (48.3 ± 1.6 µm vs 52.3 ± 1.1 µm, P = .05) and decreased cytochrome c release (0.26 ± 0.04 vs 0.46 ± 0.08, P = .04) without reaching statistical significance due to Bonferroni correction. Comparing baseline and postreperfusion levels, the hemoglobin (Hb) and blood calcium levels were lower in HTK-N (Hbbaseline : 6.0 ± 0.6 mmol/L, Hbreperfusion : 6.2 ± 0.7 mmol/L, P = .12; Ca2+ baseline : 1.36 ± 0.05 mmol/L, Ca2+ reperfusion : 1.28 ± 0.05 mmol/L, P = .16) compared to the HTK group (Hbbaseline : 5.9 ± 0.4 mmol/L, Hbreperfusion : 4.7 ± 0.8 mmol/L, P < .01; Ca2+ baseline : 1.34 ± 0.07 mmol/L, Ca2+ reperfusion : 1.24 ± 0.06 mmol/L, P < .01). The present study showed that HTK-N could positively affect the kidney during CPB. Hb and calcium levels were stabilized. A statistical trend was found showing that AKI-related proximal tubule swelling and cytochrome c release were diminished.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_dedup___::97a92379523e39b8005a928799348cf7 https://doi.org/10.1111/1440-1681.13236 Zobrazit plný text záznamu Plný text ve formátu PDF Plný text ve formátu HTML
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