Vučemilović Hrvoje, Kovač Ruben, Stanišić Lada, Sanader Vučemilović Ana, Mrčela Dina, Benzon Benjamin, Carev Mladen
Department of Anaesthesiology, University Hospital of Split, 21000 Split, Croatia.
Division of Medical Laboratory Diagnostic, University Hospital of Split, 21000 Split, Croatia.
Antioxidants (Basel). 2025 Feb 19;14(2):243. doi: 10.3390/antiox14020243.
Cardiac surgery-related acute kidney injury (CS-AKI) is a decrease in kidney function after open-heart surgery, affecting up to 50% of patients. The pathophysiology of CS-AKI involves ischemia-reperfusion injury, inflammation, and oxidative stress. Ubiquinone is a potent antioxidant, and we hypothesized that it could decrease both the incidence and severity of CS-AKI. The intervention group received ubiquinone (8 mg/kg/day) divided into three daily doses, while the control group received a placebo. The primary outcome was the incidence of CS-AKI, which was manifested as an increase in creatinine ≥26.5 µmol/L or a urine output below 0.5 mL/kg/h for 6 h. Out of 73 patients, 39.7% (N = 29) developed CS-AKI, including 35.3% of the ubiquinone group and 43.6% of the placebo group ((1,N = 73) = 0.4931, = 0.4825). The secondary outcomes revealed that the ubiquinone group experienced reduced postoperative bleeding, with a median (IQR) drainage of 320 mL (230-415) compared to the drainage of 420 mL (242.5-747.5) in the placebo group (t(35.84) = 2.055, = 0.047). The median hs-TnI level in the ubiquinone group was 239.5 ng/mL (113.25-382.75) after surgery compared to a level of 366 (234.5-672.5) ng/mL in the placebo group ( = 0.024). In conclusion, there was no significant difference in the incidence of CS-AKI between groups. Postoperative hs-TnI and bleeding were significantly reduced among patients receiving ubiquinone.
心脏手术相关急性肾损伤(CS-AKI)是心脏直视手术后肾功能的下降,影响高达50%的患者。CS-AKI的病理生理学涉及缺血再灌注损伤、炎症和氧化应激。泛醌是一种有效的抗氧化剂,我们假设它可以降低CS-AKI的发生率和严重程度。干预组接受泛醌(8毫克/千克/天),分为每日三次给药,而对照组接受安慰剂。主要结局是CS-AKI的发生率,表现为肌酐增加≥26.5微摩尔/升或尿量低于0.5毫升/千克/小时持续6小时。在73名患者中,39.7%(N = 29)发生了CS-AKI,其中泛醌组为35.3%,安慰剂组为43.6%((1,N = 73) = 0.4931, = 0.4825)。次要结局显示,泛醌组术后出血减少,中位(IQR)引流量为320毫升(230 - 415),而安慰剂组为420毫升(242.5 - 747.5)(t(35.84) = 2.055, = 0.047)。术后泛醌组的高敏肌钙蛋白I(hs-TnI)中位水平为239.5纳克/毫升(113.25 - 382.75),而安慰剂组为366(234.5 - 672.5)纳克/毫升( = 0.024)。总之,两组之间CS-AKI的发生率没有显著差异。接受泛醌治疗的患者术后hs-TnI和出血情况显著减少。