ArticleIntensive care medicine2013
Peri-operative interventions, but not inflammatory mediators, increase risk of acute kidney injury after cardiac surgery: a prospective cohort study.
Article in Intensive care medicine, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
20 citing papers in PubMed, 1 synthesis or guideline pooled it, 40 citations in OpenAlex.
- Perioperative Corticosteroid Therapy in Children Undergoing Cardiac Surgery: A Systematic Review and Meta-Analysis.Frontiers in pediatrics · 2020Pooled it
- Persistent acute kidney injury and fluid accumulation with outcomes after the Norwood procedure: report from NEPHRON.Pediatric nephrology (Berlin, Germany) · 2024Article
- Biomarkers of eGFR decline after cardiac surgery in children: findings from the ASSESS-AKI study.Pediatric nephrology (Berlin, Germany) · 2023Article
- Predicting the risk of acute kidney injury after cardiopulmonary bypass: development and assessment of a new predictive nomogram.BMC anesthesiology · 2022Article
- Inhibition of histone methyltransferase G9a effectively protected the kidney against ischemia-reperfusion injury.American journal of translational research · 2022Article
- Assessing the value of serum and urinary interleukins for diagnosis of acute kidney injury in children and adolescents: A systematic review and meta-analysis.Practical laboratory medicine · 2022Review
- Association of high-sensitivity C-reactive protein and anemia with acute kidney injury in neonates.Frontiers in pediatrics · 2022Article
- Early prediction of acute kidney injury in neonates with cardiac surgery.World journal of pediatric surgery · 2020Review
- Association of T Cell-Derived Inflammatory Cytokines With Acute Kidney Injury and Mortality After Cardiac Surgery.Kidney international reports · 2019Article
- Risk Factors for Recurrent Acute Kidney Injury in Children Who Undergo Multiple Cardiac Surgeries: A Retrospective Analysis.Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies · 2019Article
- Pharmacological interventions for the prevention of acute kidney injury after pediatric cardiac surgery: a network meta-analysis.Clinical and experimental nephrology · 2019Article
- Pharmacological approaches to cardio-renal syndrome: a role for the inodilator levosimendan.European heart journal supplements : journal of the European Society of Cardiology · 2017Article
- Brazilin exerts protective effects against renal ischemia-reperfusion injury by inhibiting the NF-κB signaling pathway.International journal of molecular medicine · 2016Article
- Early detection of acute kidney injury after pediatric cardiac surgery.Progress in pediatric cardiology · 2016Article
- Acute kidney injury after heart transplant in young children: risk factors and outcomes.Pediatric nephrology (Berlin, Germany) · 2016Article
- Interleukin-6 and interleukin-10 as acute kidney injury biomarkers in pediatric cardiac surgery.Pediatric nephrology (Berlin, Germany) · 2015Article
- Year in review in Intensive Care Medicine 2013: I. Acute kidney injury, ultrasound, hemodynamics, cardiac arrest, transfusion, neurocritical care, and nutrition.Intensive care medicine · 2014Article
- Renal effects of levosimendan: a consensus report.Cardiovascular drugs and therapy · 2013Review
- Exendin-4 and sitagliptin protect kidney from ischemia-reperfusion injury through suppressing oxidative stress and inflammatory reaction.Journal of translational medicine · 2013Article
- Dexmedetomidine protects against renal ischemia and reperfusion injury by inhibiting the JAK/STAT signaling activation.Journal of translational medicine · 2013Article
Corrections and comments
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Authors and funding
4 authors at 2 institutions in 2 countries.
Funding
Abstract
purposeCardiopulmonary bypass (CPB)-related inflammatory response might be one mechanism by which cardiac surgery associated acute kidney injury (CS-AKI) occurs. Interventions that may attenuate inflammation, including glucocorticoids or phosphodiesterase inhibitors, could therefore have a role in its prevention. We aimed to determine the role of inflammatory mediators in CS-AKI in children and the efficacy of commonly used peri-operative interventions to reduce CS-AKI risk.
methodsWe prospectively studied 109 children undergoing heart surgery. Using regression modeling (adjusting for covariates), we (1) evaluated the association between inflammatory mediators [interleukin (IL)-6, IL-8, C-reactive protein, and tumor necrosis factor-α levels] and CS-AKI, and (2) evaluated risk/prevention factors for CS-AKI including glucocorticoid and milrinone administration. CS-AKI was defined based on pRIFLE methods.
resultsCS-AKI occurred in 68% of children. No inflammatory mediator measured had an independent association with CS-AKI. Higher pre-operative glomerular filtration rate (GFR), sustained decrease in mean arterial pressure during CPB, post-operative single ventricle physiology, deep hypothermic circulatory arrest, and milrinone use at 24 h post-operatively were significant independent predictors of CS-AKI. Intra-operative steroid administration had no effect on the rate of CS-AKI.
conclusionsAlthough inflammatory mediators are up-regulated following CPB, we found no association between levels of inflammatory cytokines and CS-AKI. CS-AKI has complex pathophysiology and the observation that milrinone was associated with increased AKI risk (and that higher GFR predicts more injury) suggests that mechanisms beyond inflammation play a significant role. Intra-operative administration of glucocorticoid does not appear to be an effective intervention for reducing the risk of CS-AKI.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.