Evidence map›Paper›PMID 30181085›Full record

Trial reportJournal of cardiothoracic and vascular anesthesia2019

Impact of Isolyte Versus 0.9% Saline on Postoperative Event of Acute Kidney Injury Assayed by Urinary [TIMP-2] × [IGFBP7] in Patients Undergoing Cardiac Surgery.

Nathan M Lee, Lev Deriy, Timothy R Petersen, Vallabh O Shah, Michael P Hutchens, Neal S Gerstein

Open access · greenAbstract readRandomized Controlled Trial
In one paragraph

Trial report in Journal of cardiothoracic and vascular anesthesia, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.2field-weighted citation impact, top 49% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 6 citations in OpenAlex.

  1. Article
  2. "I don't get no respect": the role of chloride in acute kidney injury.American journal of physiology. Renal physiology · 2019
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 2 institutions in 1 country.

Nathan M LeeDepartment of Anesthesiology and Critical Care Medicine, University of New Mexico School of Medicine, Albuquerque, NM.
Lev DeriyDepartment of Anesthesiology and Critical Care Medicine, University of New Mexico School of Medicine, Albuquerque, NM.
Timothy R PetersenDepartment of Anesthesiology and Critical Care Medicine, University of New Mexico School of Medicine, Albuquerque, NM.
Vallabh O ShahDepartment of Internal Medicine, Division of Nephrology, University of New Mexico School of Medicine, Albuquerque, NM.
Michael P HutchensDepartment of Anesthesiology and Perioperative Medicine, Oregon Health & Science University, Portland, OR.
Neal S GersteinDepartment of Anesthesiology and Critical Care Medicine, University of New Mexico School of Medicine, Albuquerque, NM. Electronic address: ngerstein@gmail.com.
University of New Mexico · USOregon Health & Science University · US

Funding

NM-INBRE Sequencing and Bioinformatics CoreP20GM103451 · NIGMS · NEW MEXICO STATE UNIVERSITY LAS CRUCES · PI Charlotte C. Gard · 2012 to 2026
$61.2M
ZUNI HEALTH INITIATIVE-PILOT STUDYP20RR016480 · NCRR · NEW MEXICO STATE UNIVERSITY LAS CRUCES · PI GRIFFITH, JEFFREY K · 2001 to 2011
$33.7M
BLRD VA I01 BX004288NCRR NIH HHS P20 RR016480NIGMS NIH HHS P20 GM103451
6 · The paper itself

Abstract

objectiveAdministration of excess chloride in 0.9% normal saline (NS) decreases renal perfusion and glomerular filtration rate, thereby increasing the risk for acute kidney injury (AKI). In this study, the effect of NS versus Isolyte use during cardiac surgery on urinary levels of tissue inhibitor of metalloproteinase 2 and insulin-like growth factor-binding protein 7 [TIMP-2] × [IGFBP7] and postoperative risk of AKI were examined.

designProspective, randomized, and single-blinded trial.

settingSingle university medical center.

participantsThirty patients over 18 years without chronic renal insufficiency or recent AKI undergoing elective cardiac surgery.

interventionsSubjects were randomized to receive either NS or Isolyte during the intraoperative period. MEASUREMENTS AND MAIN

resultsThe primary outcome was the change in urinary levels of [TIMP2] × [IGFBP7] from before surgery to 24 hours postoperatively. Secondary outcomes included serum creatinine pre- and postoperatively at 24 and 48 hours, serum chloride pre- and postoperatively at 24 and 48 hours, need for dialysis prior to discharge, and arterial pH measured 24 hours postoperatively. Sixteen patients received NS and 14 patients received Isolyte. Three patients developed AKI within the first 3 postoperative days, all in the NS group. The authors found increases in [TIMP-2] × [IGFBP7] in both groups. However, the difference in this increase between study arms was not significant (p = 0.92; -0.097 to 0.107).

conclusionThe authors observed no change in urinary [TIMP-] × [IGFBP7] levels in patients receiving NS versus Isolyte during cardiac surgery. Future larger studies in patients at higher risk for AKI are recommended to evaluate the impact of high- versus lower-chloride solutions on the risk of postoperative AKI after cardiac surgery.

Indexed as

Acute Kidney InjuryAgedBiomarkersCardiac Surgical ProceduresFemaleFollow-Up StudiesGlomerular Filtration RateHumansInfusions, IntravenousInsulin-Like Growth Factor Binding ProteinsMaleMiddle AgedPostoperative ComplicationsProspective StudiesRinger's LactateROC CurveBiomarkersinsulin-like growth factor binding protein-related protein 1Insulin-Like Growth Factor Binding ProteinsRinger's LactateSaline SolutionTIMP2 protein, humanTissue Inhibitor of Metalloproteinase-20.9% salineacute kidney injurycardiac surgeryIGFBP7IsolyteTIMP-2

Identifiers

PMID30181085
PMCPMC9272898
OpenAlexW2886921111

What OpenQuestion holds

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Registered trials

None linked

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.