関連する実験動画

Updated: May 11, 2026

Induction of Nephrotic Syndrome in Mice by Retrobulbar Injection of Doxorubicin and Prevention of Volume Retention by Sustained Release Aprotinin

Induction of Nephrotic Syndrome in Mice by Retrobulbar Injection of Doxorubicin and Prevention of Volume Retention by Sustained Release Aprotinin

Published on: May 6, 2018

アプロチニンは,心臓手術患者の腎不全のリスクを増加させない

Anthony P Furnary¹, YingXing Wu, Loren F Hiratzka

¹Providence Health System, Portland, Ore, USA. Email tfurnary@starrwood.com

|September 14, 2007

まとめ

心臓外科におけるアプロチニンの使用は,急性腎不全 (ARF) の独立した危険因子ではありません. アプロチニンを投与している患者のARFの増加は,薬剤自体ではなく,より多くのパック赤血球 (PRBC) 輸血に関連しています.

科学分野:

心臓病学心臓病学
ネフロロジーはネフロロジーを用います.
アネステシオロジーアネステシオロジー

背景:

アプロチニンは,高リスクの心臓外科手術で,出血を軽減し,赤血球 (PRBC) 輸血を減らすために使用されます.
PRBC輸血は,心臓手術後の急性腎不全 (ARF) のリスクの増加と独立して関連しています.
以前の報告では,アプロチニンが独立してARFを引き起こすと示唆されており,PRBC輸血の混同効果が無視されている可能性がある.

研究の目的:

心臓外科手術患者のARFに対するアプロチニンの独立した効果を調査する.
術後のARFの危険因子を分析するために,特にPRBC輸血データを含む.
アプロチニンとARFの関連性を,潜在的な混同変数に照らして再評価する.

主な方法:

高リスクの心臓外科手術患者11,198人 (2000年1月 - 2006年2月) から将来的に収集されたデータを遡及的に分析した.
PRBC輸血データを組み込む12の変数を持つ検証されたARFリスクモデルを使用しました.
PRBC輸血データを含め,含めずにリスク調整された多変量分析を行った.

主要な成果:

アプロチニンは患者の24.6%に投与され,ARFの総発生率は1.6%でした.
ARFの発生率は,アプロチニン群 (2.6%) で非アプロチニン群 (1.3%) に比べて高く,P<0.001.
PRBCデータなしでリスク調整した分析では,アプロチニンがARFに有意な影響を及ぼすことが示された (P=0.008). しかし,PRBCデータを含めると,この効果は弱まった (P=0.231).
ARFの発生率は,PRBC輸血の数の増加 (P<0.001) により有意に増加しました.

結論:

アプロチニンを投与された患者の間で観察されたARFの増加は,この高リスク集団におけるPRBC輸血の数の増加に直接関係しています.
アプロチニンは,心臓手術患者のARFのリスクを独立して増加させない.
PRBC輸血量は,心臓外科手術後のARFの重要な独立リスク因子です.

さらに関連する動画

Improved Renal Denervation Mitigated Hypertension Induced by Angiotensin II Infusion

Improved Renal Denervation Mitigated Hypertension Induced by Angiotensin II Infusion

Published on: May 26, 2022

Technical Refinement of a Bilateral Renal Ischemia-Reperfusion Mouse Model for Acute Kidney Injury Research

Technical Refinement of a Bilateral Renal Ischemia-Reperfusion Mouse Model for Acute Kidney Injury Research

Published on: November 3, 2023

関連する概念動画

Antihypertensive Drugs: Direct Renin Inhibitors

Antihypertensive Drugs: Direct Renin Inhibitors

The renin-angiotensin-aldosterone system (RAAS) is an intricate physiological pathway involving numerous enzymes and hormones, including renin, angiotensin-converting enzyme (ACE), angiotensin I and II, and aldosterone. Imbalances within this system increase the production of angiotensin II and aldosterone. Increased angiotensin II levels promote vasoconstriction and blood pressure elevation. Concurrently, higher aldosterone levels stimulate sodium and water reabsorption in the kidneys,...

Heart Failure Drugs: Inhibitors of Renin-Angiotensin System

Heart Failure Drugs: Inhibitors of Renin-Angiotensin System

The activation of the sympathetic nervous system and the renin-angiotensin-aldosterone system (RAAS) contributes to cardiac remodeling, and inhibiting the RAAS is a pharmacological target in heart failure management. As a result, neurohumoral modulation is a crucial treatment principle for managing heart failure. This approach involves using medications like ACE inhibitors (ACEIs), angiotensin receptor blockers (ARBs), β-blockers, mineralocorticoid receptor antagonists (MRAs), and neutral...

Treatment for Pulmonary Arterial Hypertension: Prostacyclin Receptor Agonists

Treatment for Pulmonary Arterial Hypertension: Prostacyclin Receptor Agonists

Prostacyclin receptor agonists are a class of therapeutic agents integral to managing pulmonary arterial hypertension (PAH). These drugs operate by mimicking the action of prostaglandin I2, or PGI2, a naturally occurring compound in the body.
These agonists bind to the IPR receptor situated on the plasma membrane of the pulmonary artery smooth muscle cells. This binding triggers a cascade of reactions known as the GS-AC-cAMP-PKA pathway. This pathway results in the relaxation of smooth muscle...

Cardiac Catheterization I: Pre-Procedure Overview

Cardiac Catheterization I: Pre-Procedure Overview

Cardiac catheterization is an invasive diagnostic technique used to identify and evaluate structural and functional diseases of the heart and major blood vessels. This technique diagnoses congenital heart disease, coronary artery disease, valvular heart disease, and coronary spasms and assesses ventricular function. It helps guide treatment decisions, including the need for revascularization procedures like percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) and...

Kidney Transplant II: Surgical Procedure

Kidney Transplant II: Surgical Procedure

Preoperative ManagementThe primary goals of preoperative management in kidney transplantation are to optimize the patient’s metabolic state and prepare them for surgery through diet adjustments, necessary dialysis, and tailored medical treatment. This phase also involves comprehensive infection screening and patient education about the surgical procedure and postoperative care to improve outcomes and adherence.Medical ManagementA comprehensive evaluation is required for both the living donor...

Acute Kidney Injury IV: Diagnostic Studies and Prevention

Acute Kidney Injury IV: Diagnostic Studies and Prevention

Accurate diagnosis and effective prevention are critical in managing Acute Kidney Injury (AKI), which is linked to high mortality rates ranging from 10% to 80%. Timely recognition of at-risk patients and careful monitoring can significantly reduce the likelihood of kidney damage.Diagnostic Assessments:The diagnostic process starts with a comprehensive medical history to identify prerenal, intrarenal, and postrenal causes.Prerenal causes, such as dehydration, hypotension, or blood loss, should...