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[Effects of ambroxol on renal function in children undergoing cardiopulmonary bypass]
Jian-Hua Liu1, Cai-Jiao Xie, Li Li
1Department of Anesthesiology, Second Xiangya Hospital, Central South University, Changsha, China. xcj484@yahoo.com.cn
Insights
Ambroxol effectively reduces kidney damage in children undergoing cardiopulmonary bypass (CPB) for ventricular septal defect (VSD) repair. This study shows ambroxol administration protects renal function during CPB procedures.
Area of Science:
- Cardiology
- Nephrology
- Pediatric Surgery
Context:
- Cardiopulmonary bypass (CPB) is associated with potential renal injury in pediatric patients.
- Ambroxol has demonstrated lung-protective effects, but its impact on kidney function during CPB is not well-established.
Purpose:
- To investigate the efficacy of ambroxol in preventing renal injury in children undergoing CPB for ventricular septal defect (VSD) repair.
- To evaluate the effect of ambroxol on specific renal biomarkers post-CPB.
Summary:
- A randomized controlled trial involving 40 children (3-8 years) undergoing VSD repair with CPB compared ambroxol treatment to a saline control.
- Serum and urinary biomarkers of kidney injury, including creatinine, beta(2)-microglobulin, retinol-binding protein, and N-acetyl-beta-D-glucosaminidase, were measured at multiple time points.
- Ambroxol administration significantly reduced levels of these renal injury markers compared to the control group.
Impact:
- Ambroxol administration prior to CPB demonstrates a protective effect against CPB-induced renal injury in pediatric VSD repair.
- Findings suggest a potential therapeutic role for ambroxol in mitigating kidney damage during cardiac surgery in children.
- Further investigation into the underlying mechanisms of ambroxol's renoprotective effects is warranted.
Objective:
Some research has shown that ambroxol can alleviate lung injury induced by cardiopulmonary bypass (CPB). However, whether ambroxol has protective effects against CPB-induced renal injury remains unknown. This study investigated the effect of ambroxol on renal function in children undergoing CPB.
Methods:
Forty children at ages of 3-8 years with cardiac function class I or II and weighing 12-25 kg, underwent repair of ventricular septal defect (VSD) under CPB. They were randomly divided into two groups (n=20 each):control and ambroxol-treated. The children in the ambroxol-treated group received ambroxol of 4.5 mg/kg in 10 mL normal saline by intravenous injection after skin incision. The control group received 10 mL of normal saline instead. Serum concentrations of urea nitrogen (BUN), beta(2)-microglobulin (beta(2)-MG) and creatinine (Cr) and urinary beta(2)-MG, retinol-binding-protein (RBP) and N-acetyl-beta-D-glucosaminidase (NAG) were measured before operation, and 2, 12, 24 and 48 hrs after operation.
Results:
Serum Cr and urinary beta(2)-MG concentrations 2 hrs after operation, serum beta(2)-MG concentration 2 and 12 hrs after operation, urinary RBP concentration 2, 12, 24 and 48 hrs after operation, and urinary NAG concentration 2, 12 and 24 hrs after operation in the control and the ambroxol-treated groups increased significantly as compared with their baseline values (before operation) (P<0.05). Serum Cr concentration 2 hrs after operation, serum beta(2)-MG and urinary beta(2)-MG concentrations 2 and 12 hrs after operation, urinary RBP concentration 2, 12, 24 and 48 hrs after operation, and urinary NAG concentration 12 and 24 hrs after operation in the ambroxol-treated group were significantly lower than those in the control group (P<0.05).
Conclusions:
Ambroxol administration before CPB is effective in reducing CPB-induced renal injury in children undergoing repair of VSD. Further research is required to understand the mechanism.
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