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Effects of Oral Protein Load on Kidney Function in Patients Undergoing Cardiac Surgery

2018年11月18日 更新者:Faeq Husain、University of Giessen

Effects of Preoperative High Oral Protein Load on Short- and Long-term Renal Outcomes Following Cardiac Surgery - a Matched Case-control Study

Acute kidney injury (AKI) occurs in approximately one-third of patients undergoing cardiac surgery (CS), and represents one of the most significant negative predictors of patient outcome in this population. In the healthy adult, a high protein meal is known to enhance glomerular filtration rate and is mediated by an increase in renal blood flow. The investigators hypothesized that preoperative oral protein load may precondition the kidneys for upcoming insults and reduce the rate of postoperative AKI and long-term renal outcome.

研究概览

地位

完全的

干预/治疗

详细说明

Acute kidney injury (AKI) occurs in approximately one-third of patients undergoing cardiac surgery (CS), and represents one of the most significant negative predictors of patient outcome in this population. To date, there is no therapy to prevent AKI. In the healthy adult, a high protein meal is known to enhance glomerular filtration rate (GFR) and is mediated by an increase in renal blood flow. The investigators hypothesized that preoperative oral protein load may induce an adaptive response of the kidneys, and precondition the kidneys for upcoming insults. In the present study, the investigators aimed to compare the prevalence and severity of AKI in patients undergoing oral high protein load of the 'Preoperative Renal Functional Reserve Predict Risk of AKI after Cardiac Operation' study to age- and gender-matched "controls" who had a standard preoperative care the day prior to surgery within the same period (November 2014-October 2015) at San Bortolo Hospital, Vicenza, Italy. Both groups were followed 1 year post-discharge to evaluate long-term renal outcomes.

研究类型

观察性的

注册 (实际的)

214

参与标准

研究人员寻找符合特定描述的人,称为资格标准。这些标准的一些例子是一个人的一般健康状况或先前的治疗。

资格标准

适合学习的年龄

  • 孩子
  • 成人
  • 年长者

接受健康志愿者

有资格学习的性别

全部

取样方法

概率样本

研究人群

Adult patients with estimated GFR ≥60 ml/min/1.73 m2 (CKD-Epidemiology Collaboration equation) undergoing elective cardiac surgery (coronary artery bypass, valve replacements, combined or other surgery, with cardiopulmonary bypass) between November 2014 and October 2015 at the San Bortolo Hospital, Vicenza, Italy

描述

Inclusion Criteria:

  1. Subjects older than 18 years undergoing elective cardiac surgery
  2. Subjects older than 18 years with an estimated eGFR >60 ml/min/1.73 m2 (CKD-EPI)
  3. Subjects who signed informed consent forms

Exclusion Criteria:

  1. Pregnancy
  2. Chronic kidney disease ≥ stage III (KDIGO criteria)
  3. Preexisting acute kidney injury (as determined by all available serum creatinine values from hospital and outpatient medical records within the previous 90 days)
  4. Solitary kidney
  5. Diabetes mellitus type 1
  6. Recent cardiac arrest or myocardial infarction up to 7 days before surgery
  7. Liver failure or cirrhosis
  8. Total parenteral nutrition
  9. Haemoglobin <11 g/dl
  10. Sepsis
  11. History of malabsorption, chronic inflammatory bowel disease, short bowel, or pancreatic insufficiency
  12. Transplant donor or recipient
  13. Active autoimmune disease with renal involvement
  14. Rhabdomyolysis
  15. Prostate hypertrophy with International Prostate Symptom Score ≥20
  16. Transcatheter aortic valve implantation
  17. Active neoplasm
  18. Patients who did not pause angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers or received non-steroidal anti-inflammatory drugs a minimum of 48 hours before hospital admission.
  19. Patients who received intravenous radiocontrast agents within the 72 hours before hospital admission.

学习计划

本节提供研究计划的详细信息,包括研究的设计方式和研究的衡量标准。

研究是如何设计的?

设计细节

队列和干预

团体/队列
干预/治疗
Cardiac Surgery
214 adult patients with estimated GFR ≥60 ml/min/1.73 m2 (CKD-Epidemiology Collaboration equation) undergoing elective cardiac surgery (coronary artery bypass, valve replacements, combined or other surgery, with cardiopulmonary bypass) between November 2014 and October 2015 at the San Bortolo Hospital, Vicenza, Italy

研究衡量的是什么?

主要结果指标

结果测量
措施说明
大体时间
Occurrence of AKI after cardiac surgery
大体时间:7 days
using full Kidney Disease: Improving Global Outcomes criteria
7 days
Long-term change in estimated GFR
大体时间:3 months and 1 year after cardiac surgery
using CKD-Epidemiology Collaboration creatinine formula
3 months and 1 year after cardiac surgery

合作者和调查者

在这里您可以找到参与这项研究的人员和组织。

调查人员

  • 研究主任:Claudio Ronco, MD、International Renal Research Institute of Vicenza, Vicenza, Italy

出版物和有用的链接

负责输入研究信息的人员自愿提供这些出版物。这些可能与研究有关。

研究记录日期

这些日期跟踪向 ClinicalTrials.gov 提交研究记录和摘要结果的进度。研究记录和报告的结果由国家医学图书馆 (NLM) 审查,以确保它们在发布到公共网站之前符合特定的质量控制标准。

研究主要日期

学习开始 (实际的)

2014年11月1日

初级完成 (实际的)

2015年10月31日

研究完成 (实际的)

2016年11月24日

研究注册日期

首次提交

2017年3月30日

首先提交符合 QC 标准的

2017年3月30日

首次发布 (实际的)

2017年4月5日

研究记录更新

最后更新发布 (实际的)

2018年11月20日

上次提交的符合 QC 标准的更新

2018年11月18日

最后验证

2018年11月1日

更多信息

与本研究相关的术语

其他研究编号

  • 79/16 F

计划个人参与者数据 (IPD)

计划共享个人参与者数据 (IPD)?

是的

IPD 计划说明

All IPD that underlie results in a publication

IPD 共享时间框架

Starting immediately after results have been published

IPD 共享访问标准

by email request to first author

IPD 共享支持信息类型

  • 树液

药物和器械信息、研究文件

研究美国 FDA 监管的药品

研究美国 FDA 监管的设备产品

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