Salutary effect of reduced glutathione on renal function in coronary artery bypass operation.

BACKGROUND

Renal dysfunction and acute renal failure are serious complications of open heart operations. Previous reports have suggested beneficial effects of exogenous glutathione for preservation of renal function after ischemic renal injury. We prospectively studied the effect of perioperative administration of glutathione on renal function in patients who underwent coronary artery bypass operation.

STUDY DESIGN

Two hundred mg per kg of glutathione was administered to the treated group (n = 10) before cardiopulmonary bypass, and on the first and second postoperative days. The control group was administered placebo in the same volume. Hemodynamics, renal function, and plasma hormone levels were measured consecutively.

RESULTS

In the glutathione group, the mean arterial pressure and systemic vascular resistance index were lower than in the control group. Urine volume, creatinine clearance, and renal excretory index were well preserved in the group treated with glutathione. Moreover, the fractional excretion of sodium was lower and urine and plasma osmolarity was higher in the group treated with glutathione. No differences in plasma renin activity, angiotensin II, or aldosterone concentrations between the two groups were observed.

CONCLUSIONS

Perioperative glutathione treatment has a salutary effect on perioperative renal function through effects on both renal hemodynamics and tubular mechanism.