Afzal Golnaz, Ansari Aval Zahra, Beheshti Monfared Mahmoud, Khesali Hamed, Ziaie Shadi, Barati Saghar, Dastan Farzaneh
Department of Clinical Pharmacy, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Clinical Research and Development Center at Shahid Modarress Hospital, Department of Cardiac Surgery, Shahid Beheshti of Medical Sciences, Tehran, Iran.
Iran J Pharm Res. 2021 Fall;20(4):71-79. doi: 10.22037/ijpr.2021.115334.15323.
Acute kidney injury (AKI) is a common complication after coronary artery bypass grafting (CABG) surgery and can be linked to the increased morbidity and mortality. Therefore, in the present study, the effect of preoperative administration of acetazolamide was evaluated to investigate whether it could prevent occurrence of post-operative AKI after CABG surgery. In this randomized controlled clinical trial, 130 patients who were candidates to undergo elective CABG surgery from January 21, 2020 to February 8, 2021 were randomly allocated to intervention group (receiving 500 mg of acetazolamide orally 2 h preoperatively) and control group. The patients were evaluated for AKI based on the kidney disease- improving global outcomes (KDIGO) criteria based on their serum creatinine (SCr) level and urine output until 7 days postoperatively. There was no significant difference in baseline demographics between the two groups. The total incidence of AKI was measured as 43%. Analysis of post-operative AKI incidence showed no statistically significant difference between the two groups ( = 0.860). Mean post-operative SCr level on day 1 was significantly higher in the acetazolamide group ( = 0.036). A significant difference was found in length of hospitalization stay between the groups, which was higher in the control group ( = 0.006). Our results did not demonstrate a significant protective effect of acetazolamide on incidence of post-operative AKI in the patients undergone elective on-pump CABG surgery.
急性肾损伤(AKI)是冠状动脉旁路移植术(CABG)术后常见的并发症,并且可能与发病率和死亡率的增加有关。因此,在本研究中,评估了术前给予乙酰唑胺的效果,以调查其是否能预防CABG术后AKI的发生。在这项随机对照临床试验中,将2020年1月21日至2021年2月8日期间计划接受择期CABG手术的130例患者随机分为干预组(术前2小时口服500mg乙酰唑胺)和对照组。根据肾病改善全球预后(KDIGO)标准,依据患者血清肌酐(SCr)水平和尿量,对患者术后7天内的AKI情况进行评估。两组患者的基线人口统计学特征无显著差异。AKI的总发生率为43%。术后AKI发生率分析显示两组之间无统计学显著差异(P = 0.860)。乙酰唑胺组术后第1天的平均SCr水平显著更高(P = 0.036)。两组之间的住院时间存在显著差异,对照组更长(P = 0.006)。我们的结果未显示乙酰唑胺对接受择期体外循环CABG手术患者的术后AKI发生率有显著保护作用。