Prophylactic Methylprednisolone for Renal Protection in Cardiac Surgeries With Cardiopulmonary Bypass

April 4, 2025 updated by: Ain Shams University

Prophylactic Methylprednisolone for Renal Protection in Cardiac Surgeries With Cardiopulmonary Bypass: A Randomized Double-Blinded Clinical Study

The aim of the planned study is to assess the prophylactic effect of intraoperative administration of a single dose of methylprednisolone 2 (mg/kg) in decreasing the incidence of postoperative acute kidney injury after cardiac surgeries with cardiopulmonary bypass.

Study Overview

Status

Recruiting

Conditions

Intervention / Treatment

Detailed Description

Patients undergoing any type of elective cardiac surgical procedure requiring CPB will be randomly assigned into one of the following groups

  1. Placebo group / Control group will receives normal saline as a placebo after the induction of anesthesia and before initiating CPB.
  2. Methylprednisolone group / Interventional group receives a single intra-venous dose of methylprednisolone (2 mg/kg) after the induction of anesthesia, and before the initiation of CPB.

Measurements:

Primary outcome:

Incidence of occurrence of postoperative acute kidney injury for 7 days according to the RIFLE criteria.

Secondary outcome:

  1. Incidence of postoperatively hyperglycemia (blood glucose level of ≥ 140 mg/dl) for 7 days,
  2. Duration of ICU stay,
  3. Length of hospital stay (LOS),
  4. Incidence of wound infection,
  5. Incidence of peptic ulcer,
  6. Incidence of sepsis.

Study Type

Interventional

Enrollment (Estimated)

170

Phase

  • Phase 1

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Locations

    • Abbasia
      • Cairo, Abbasia, Egypt, 00202
        • Recruiting
        • Ain Shams University
        • Contact:

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  1. Age 18-65 years.
  2. Sex: Both sexes.
  3. Patients with American Society of Anesthesiologists (ASA) score III-IV.
  4. Patients scheduled for any kind of elective cardiac surgical procedure requiring cardiopulmonary bypass (e.g., coronary artery bypass grafting (CABG), valve repair/replacement, or combined procedures (

Exclusion Criteria:

  1. Declining to give written informed consent.
  2. History of allergy to the medications used in the study.
  3. Diabetic patients with HbA1C >6.5
  4. Moderate to severe hepatic diseases (Child B-C)
  5. Hepatic dysfunction: INR > 1.5, serum albumin < 2.9 g%.
  6. Renal dysfunction (serum Creatinine level >1.3 mg/dl, or GFR < 80 ml/min./1.73/m2
  7. Patients with a recent history of AKI.
  8. Patients undergoing urgent cardiac surgery.
  9. Patients undergoing cardiac surgeries with deep hypothermic total circulatory arrest.
  10. Planned off-pump procedure.
  11. Any cardiac surgery exceeds 45 minutes on Aortic cross clamp.
  12. Patients requiring high doses of inotropes and/or vasopressors intraoperative or postoperative (high-dose dopamine is defined as peak doses of >15 μg/kg/min, high-dose norepinephrine is defined as peak dose >0.1 μg/kg/min, high-dose epinephrine is defined as peak dose >0.1 μg/kg/min)
  13. Delayed extubation for more than 6 hours postoperative.
  14. Patients developed postoperative complications as (septic shock and bleeding)

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Prevention
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Triple

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
No Intervention: Control group
(Placebo group / Control group) will receive normal saline as a placebo after the induction of anesthesia and before initiating CPB.
Active Comparator: Methylprednisolone group
(Methylprednisolone group ) receive a single intra-venous dose of methylprednisolone (2 mg/kg) after the induction of anesthesia, and before the initiation of CPB.
In this study patients will be given a single intra-venous dose of methylprednisolone (2 mg/kg) after the induction of anesthesia, and before the initiation of CPB.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Incidence of occurrence of postoperative acute kidney injury
Time Frame: 7 days post-operative
Incidence of occurrence of postoperative acute kidney injury for 7 days according to the RIFLE criteria.
7 days post-operative

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Incidence of postoperatively hyperglycemia
Time Frame: 7 days post-operative
1. Incidence of postoperatively hyperglycemia (blood glucose level of ≥ 140 mg/dl).
7 days post-operative
Duration of ICU stay,
Time Frame: 7 days post-operative
Duration of ICU stay,
7 days post-operative
Length of hospital stay
Time Frame: 14 Day post-operative
Length of hospital stay
14 Day post-operative
Incidence of wound infection
Time Frame: 7 days post-operative
Incidence of wound infection
7 days post-operative
Incidence of peptic ulcer
Time Frame: 7 days post-operative
Monitoring attacks of hematemesis or melena
7 days post-operative
Incidence of sepsis
Time Frame: 7 days post-operative
Incidence of sepsis.
7 days post-operative

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

February 1, 2025

Primary Completion (Estimated)

February 1, 2026

Study Completion (Estimated)

December 1, 2026

Study Registration Dates

First Submitted

February 14, 2025

First Submitted That Met QC Criteria

April 4, 2025

First Posted (Actual)

April 9, 2025

Study Record Updates

Last Update Posted (Actual)

April 9, 2025

Last Update Submitted That Met QC Criteria

April 4, 2025

Last Verified

February 1, 2025

More Information

Terms related to this study

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

product manufactured in and exported from the U.S.

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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