[Clinical effects of alprostadil injection on acute kidney injury after cardiac surgical procedures].
Author(s): Xue Q, Xu ZY, Han L, Li BL, Wang C, Yan T, Zhong K, Li X, Zhang GX
Affiliation(s): Department of Cardiothoracic Surgery, Changhai Hospital, Second Military Medical University, Shanghai 200433, China.
Publication date & source: 2010-08-24, Zhonghua Yi Xue Za Zhi., 90(32):2266-9.
Publication type: English Abstract; Randomized Controlled Trial
OBJECTIVE: To explore the clinical effects of alprostadil injection on acute kidney injury (AKI) after cardiac surgical procedures by a prospective randomized controlled trial. METHODS: A total of 63 AKI-patients after cardiac surgical procedures were randomly divided into the control group (n = 31) and the study group (n = 32). All patients received routine therapy while patients in the study group were additionally given alprostadil injection (10 microg i.v. once every 12 hours) for 7 days. A 11-year-old patient weighing 29 kg was given half of the conventional dose. During the period of control treatment (7 days), 1 patient in the control group and 2 patients in the study group were excluded because of hemodialysis or peritoneal dialysis. Urine volume, urine beta-N-acetylglucosaminidase, urine alpha(1)-microglobulin, urine beta(2)-microglobulin, serum creatinine and blood urea nitrogen were measured before and after the control treatment. And the ICU stay duration and the percentage of dialysis after the control treatment were calculated. Adverse reactions of alprostadil injection were observed simultaneously in the study group. RESULTS: After the treatment, urine volume in the study group was obviously more than that in the control group [(65.9 +/- 3.1) ml/h vs (58.8 +/- 4.5) ml/h, P < 0.05] while urine beta-N-acetylglucosaminidase, urine alpha(1)-microglobulin, urine beta(2)-microglobulin, serum creatinine and blood urea nitrogen in the study group were obviously lower than those in the control group (all P < 0.05). The ICU stay duration in the study group was obviously less than that in the control group [(12 +/- 5) d vs (17 +/- 5) d, P < 0.05]. But there was no significant difference in the percentage of dialysis after the control treatment between two groups (3.3% vs 6.7%, P > 0.05). And no serious adverse reaction was reported in the study group. CONCLUSION: On the basis of routine therapy, alprostadil injection may promote the recovery of renal function in AKI-patients after cardiac surgical procedures.