ASN's Mission

To create a world without kidney diseases, the ASN Alliance for Kidney Health elevates care by educating and informing, driving breakthroughs and innovation, and advocating for policies that create transformative changes in kidney medicine throughout the world.

learn more

Contact ASN

1401 H St, NW, Ste 900, Washington, DC 20005

email@asn-online.org

202-640-4660

The Latest on X

Kidney Week

ASN / Education & Meetings / Kidney Week /

Please note that you are viewing an archived section from 2019 and some content may be unavailable. To unlock all content for 2019, please visit the archives.

Abstract: TH-PO1183

Kidney Protection Using the RenalGuard® System in Cardiac Surgery (KIDNEY Study): A Randomised Control Trial Assessing AKI Rate

Session Information

Category: Acute Kidney Injury

  • No subcategory defined

Authors

  • Luckraz, Heyman, American Hospital Dubai, Dubai, United Arab Emirates
  • Giri, Ramesh, The Royal Wolverhampton NHS Trust, Wolverhampton, United Kingdom
  • Wrigley, Benjamin John, The Royal Wolverhampton NHS Trust, Wolverhampton, United Kingdom
  • Nagarajan, Kumaresan, The Royal Wolverhampton NHS Trust, Wolverhampton, United Kingdom
  • Beare, Lawrence, The Royal Wolverhampton NHS Trust, Wolverhampton, United Kingdom
  • Senanayake, Eshan, The Royal Wolverhampton NHS Trust, Wolverhampton, United Kingdom
  • Sharman, Emma Louise, The Royal Wolverhampton NHS Trust, Wolverhampton, United Kingdom
  • Nevill, Alan M, University of Wolverhampton, Walsall, United Kingdom
Background

Acute kidney injury (AKI) after cardiac surgery occurs in up to 30% of patients & is associated with significant morbidity & mortality. RenalGuard® system (RG) has been shown to reduce AKI rates in patients undergoing Percutaneous Cardiac Intervention (PCI, TAVR). This study investigated the efficacy & safety of balanced forced diuresis using the RenalGuard® system in cardiac surgical patients requiring cardiopulmonary bypass (CPB)

Methods

Patients at risk of developing AKI during cardiac surgery (history of diabetes &/or anemia, e-GFR < 60 ml/min/1.73m2, anticipated CPB time > 120 minutes, Log EuroScore >5) were randomized to either RG (n=110) or managed as per current management strategy (control=110). Primary end-point was the development of AKI, defined by RIFLE criteria, within first 3 days of surgery. (Trial registration:NCT02974946)

Results

There were no significant differences in patients’ pre & intra-operative characteristics (age, gender, LVEF, surgery type, Log EuroScore, pre-op creatinine & e-GFR levels, CPB & cross-clamp times & pre-op history of diabetes, peripheral vascular disease & renal impairment) between the 2 groups. Post-operative AKI rates were significantly lower in RG group compared to control (10% (11/110) v/s 20.9% (23/110), p=0.025). Binary logistic regression analysis confirmed RG system to be independently associated with significant AKI reduction (OR 2.82, 95%CI 1.20 – 6.60, p=0.017). The mean volumes of urine produced during surgery (2337+/-896 ml v/s 766+/-557 ml) & within first 24 hours post-op (3297 +/- 1298 ml v/s 2053 +/- 802 ml) were significantly higher in RG group (p<0.01). There was no significant difference in the incidence of blood transfusions, atrial fibrillation, infections, cerebro-vascular events, median ICU and in-hospital stays between the two groups. One patient in the RG group & two patients in the control group died prior to hospital discharge. The number needed to treat (NNT) with the RG system to prevent AKI was 9 patients

Conclusion

In patients at-risk for AKI, undergoing cardiac surgery with the CPB, the RenalGuard® system significantly reduced the incidence of AKI and can be used safely & reproducibly. Larger studies will be required to assess the cost benefit of this device

Funding

  • Other NIH Support –