Study shows amino acids reduce acute kidney injury after cardiac surgery

Among adult patients undergoing cardiac surgery, infusion of amino acids reduces the occurrence of acute kidney injury (AKI), according to a study published online June 12 in the New England Journal of Medicine to coincide with the annual Critical Care Reviews Meeting, held from June 12 to 14 in Belfast, Northern Ireland.

Giovanni Landoni, M.D., from the IRCCS San Raffaele Scientific Institute in Milan, and colleagues examined the efficacy of amino acids in reducing the occurrence of AKI after cardiac surgery. The analysis included 3,511 adult patients who were scheduled to undergo cardiac surgery with cardiopulmonary bypass who were randomly assigned to receive an intravenous infusion of either a balanced mixture of amino acids (2 g per kilogram of ideal body weight per day) or placebo (Ringer's solution) for up to three days.

The researchers found that AKI occurred in 26.9% of patients in the amino acid group and in 31.7% of the placebo group (relative risk, 0.85). Stage 3 AKI occurred in 1.6 and 3.0% of patients, respectively (relative risk, 0.56). Kidney replacement therapy was needed in 1.4% of patients in the amino acid group versus 1.9% in the placebo group. Secondary outcomes and reports of adverse events were found to be similar between the groups.

"These findings appear to be clinically and epidemiologically important because they may apply to more than two million patients who undergo heart surgery worldwide every year and because AKI is an independent risk factor for subsequent chronic kidney disease," the authors write.

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