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Effects of Ulinastatin on Postoperative Renal Function in Patients Undergoing Cardiac Surgery with Cardiopulmonary

Huanran Lv1, Qian Li1, Yuda Fei2

  • 1State Key Laboratory of Cardiovascular Disease, Department of Anesthesiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

Cardiorenal Medicine
|June 14, 2023
PubMed

Insights

Ulinastatin significantly reduced acute kidney injury and respiratory failure in cardiac surgery patients. However, it did not improve long-term survival or reduce mortality in this study.

Area of Science:

  • Cardiology
  • Nephrology
  • Critical Care Medicine

Background:

  • Cardiac surgery with cardiopulmonary bypass (CPB) carries risks of acute kidney injury (AKI) and other complications.
  • Ulinastatin is a protease inhibitor with potential protective effects.

Purpose of the Study:

  • To investigate the effect of ulinastatin on renal function and long-term survival in patients undergoing cardiac surgery with CPB.
  • To assess the impact of ulinastatin on postoperative AKI, respiratory failure, and survival rates.

Main Methods:

  • Prospective cohort study at Fuwai Hospital, China.
  • Ulinastatin administered after anesthesia induction.
  • Primary outcome: new-onset postoperative AKI. Secondary outcomes included renal replacement therapy, inflammatory markers (pNGAL, IL-6), respiratory failure, and 10-year survival.

Main Results:

  • Significantly lower incidence of new-onset AKI in the ulinastatin group (20.00% vs. 32.40%, p = 0.009).
  • Reduced postoperative plasma neutrophil gelatinase-associated lipocalin (pNGAL) and IL-6 levels.
  • Significantly lower incidence of respiratory failure (0.76% vs. 5.40%, p = 0.02).
  • No significant difference in renal replacement therapy, intensive care unit/hospital stays, mortality, or 10-year survival rates.

Conclusions:

  • Ulinastatin effectively reduces postoperative AKI and respiratory failure in patients undergoing cardiac surgery with CPB.
  • Ulinastatin does not improve long-term survival or reduce mortality in this patient population.
Abstract

Keywords:
Acute kidney injuryCardiac surgical proceduresCardiopulmonary bypassUlinastatin

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