Department of Cardiovascular Anaesthesiology and Intensive Care, Emergency Institute for Cardiovascular Diseases "Prof Dr C C Iliescu", 258 Fundeni Road, 022328 Bucharest, Romania.
Faculty of General Medicine, Carol Davila University of Medicine and Pharmacy, 8 Eroii Sanitari Blvd, 050474 Bucharest, Romania.
Medicina (Kaunas). 2024 May 3;60(5):761. doi: 10.3390/medicina60050761.
Acute kidney injury represents a significant threat in cardiac surgery regarding complications and costs. Novel preventive approaches are needed, as the therapeutic modalities are still limited. As experimental studies have demonstrated, glutamine, a conditionally essential amino acid, might have a protective role in this setting. Moreover, the levels of glutamine after the cardiopulmonary bypass are significantly lower. In clinical practice, various trials have investigated the effects of glutamine supplementation on cardiac surgery with encouraging results. However, these studies are heterogeneous regarding the selection criteria, timing, dose, outcomes studied, and way of glutamine administration. This narrative review aims to present the potential role of glutamine in cardiac surgery-associated acute kidney injury prevention, starting from the experimental studies and guidelines to the clinical practice and future directions.
急性肾损伤是心脏手术中一个严重的并发症，不仅关乎患者的安危，也与治疗费用息息相关。目前，针对心脏手术后急性肾损伤，我们仍缺乏有效的治疗手段，因此急需探索新的预防策略。有实验研究表明，谷氨酰胺作为一种条件必需氨基酸，在这种情况下可能具有保护作用。此外，体外循环后患者体内的谷氨酰胺水平显著降低。在临床实践中，已有多项研究探讨了谷氨酰胺补充对心脏手术的影响，结果令人鼓舞。然而，这些研究在选择标准、时机、剂量、研究终点以及谷氨酰胺给药途径等方面存在异质性。本综述旨在从实验研究和指南，到临床实践和未来方向，探讨谷氨酰胺在心脏手术相关急性肾损伤预防中的潜在作用。
