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dc.contributor.authorLuckraz, Heyman
dc.contributor.authorGiri, Ramesh
dc.contributor.authorWrigley, Benjamin
dc.contributor.authorNagarajan, Kumaresan
dc.contributor.authorSenanayake, Eshan
dc.contributor.authorSharman, Emma
dc.contributor.authorBeare, Lawrence
dc.contributor.authorNevill, Alan
dc.date.accessioned2020-12-01T10:39:08Z
dc.date.available2020-12-01T10:39:08Z
dc.date.issued2020-11-25
dc.identifier.citationLuckraz, H., Giri, R., Wrigley, B., Nagarajan, K., Senanayake, E., Sharman, E., Beare, L. and Nevill, A. (2020) Reduction in acute kidney injury post cardiac surgery using balanced forced diuresis: a randomized, controlled trial, European Journal of Cardio-Thoracic Surgery. https://doi.org/10.1093/ejcts/ezaa395en
dc.identifier.issn1010-7940en
dc.identifier.doi10.1093/ejcts/ezaa395en
dc.identifier.urihttp://hdl.handle.net/2436/623805
dc.description© 2020 The Authors. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. This is an open access article available under a Creative Commons licence. The published version can be accessed at the following link on the publisher’s website: https://doi.org/10.1093/ejcts/ezaa395en
dc.description.abstractOBJECTIVES Our goal was to investigate the efficacy of balanced forced diuresis in reducing the rate of acute kidney injury (AKI) in cardiac surgical patients requiring cardiopulmonary bypass (CPB), using the RenalGuard® (RG) system. METHODS Patients at risk of developing AKI (history of diabetes and/or anaemia; estimated glomerular filtration rate 20–60 ml/min/1.73 m2; anticipated CPB time >120 min; log EuroSCORE > 5) were randomized to the RG system group (n = 110) or managed according to current practice (control = 110). The primary end point was the development of AKI within the first 3 postoperative days as defined by the RIFLE (Risk, Injury, Failure, Loss of kidney function, End-stage renal disease) criteria. RESULTS There were no significant differences in preoperative and intraoperative characteristics between the 2 groups. Postoperative AKI rates were significantly lower in the RG system group compared to the control group [10% (11/110) vs 20.9% (23/110); P = 0.025]. This effect persisted even after controlling for a number of potential confounders (odds ratio 2.82, 95% confidence interval 1.20–6.60; P = 0.017) when assessed by binary logistic regression analysis. The mean volumes of urine produced during surgery and within the first 24 h postoperatively were significantly higher in the RG system group (P < 0.001). There were no significant differences in the incidence of blood transfusions, atrial fibrillation and infections and in the median duration of intensive care unit stays between the groups. The number needed to treat with the RG system to prevent AKI was 9 patients (95% confidence interval 6.0–19.2). CONCLUSIONS In patients at risk for AKI who had cardiac surgery with CPB, the RS RG system significantly reduced the incidence of AKI and can be used safely and reproducibly. Larger studies are required to confirm cost benefits.en
dc.description.sponsorshipThis work was supported by RenalGuard Solutions; and National Institute of Healthcare Research (NIHR), Clinical Research Network, UK [Ref: NIHR CRN No 32769].en
dc.formatapplication/pdfen
dc.languageen
dc.language.isoenen
dc.publisherOxford University Pressen
dc.relation.urlhttps://academic.oup.com/ejcts/advance-article/doi/10.1093/ejcts/ezaa395/6000632en
dc.subjectacute kidney injuryen
dc.subjectcardiac surgeryen
dc.subjectRenalGuarden
dc.subjectsystemen
dc.titleReduction in acute kidney injury post cardiac surgery using balanced forced diuresis: a randomized, controlled trialen
dc.typeJournal articleen
dc.identifier.eissn1873-734X
dc.identifier.journalEuropean Journal of Cardio-Thoracic Surgeryen
dc.date.updated2020-11-26T12:21:58Z
dc.date.accepted2020-09-16
rioxxterms.funderRenalGuard Solutions, National Institute of Healthcare Research (NIHR), Clinical Research Network, UKen
rioxxterms.identifier.projectNIHR CRN No 32769en
rioxxterms.versionVoRen
rioxxterms.licenseref.urihttps://creativecommons.org/licenses/by-nc/4.0/en
rioxxterms.licenseref.startdate2020-12-01en
dc.description.versionPublished online
refterms.dateFCD2020-12-01T10:38:15Z
refterms.versionFCDVoR
refterms.dateFOA2020-12-01T10:39:09Z


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