Abstract: PO0228
Restriction of Sulfur-Containing Amino Acid Intake for Prevention of AKI in Cardiac Surgery: UNICORN, a Randomized, Controlled, Double-Blinded Trial
Session Information
- AKI: Clinical, Outcomes, and Trials
November 04, 2021 | Location: On-Demand, Virtual Only
Abstract Time: 10:00 AM - 12:00 PM
Category: Acute Kidney Injury
- 102 AKI: Clinical, Outcomes, and Trials
Authors
- Osterholt, Thomas, Department II of Internal Medicine and Center for Molecular Medicine Cologne, University of Cologne, Cologne, Germany
- Gloistein, Claas, Department II of Internal Medicine and Center for Molecular Medicine Cologne, University of Cologne, Cologne, Germany
- Todorova, Polina, Department II of Internal Medicine and Center for Molecular Medicine Cologne, University of Cologne, Cologne, Germany
- Becker, Ingrid, Institute of Medical Statistics and Computational Biology, University of Cologne, Cologne, Germany
- Arenskrieger, Katja, Department II of Internal Medicine and Center for Molecular Medicine Cologne, University of Cologne, Cologne, Germany
- Melka, Ramona, Department II of Internal Medicine and Center for Molecular Medicine Cologne, University of Cologne, Cologne, Germany
- Koehler, Felix C., Department II of Internal Medicine and Center for Molecular Medicine Cologne, University of Cologne, Cologne, Germany
- Benzing, Thomas, Department II of Internal Medicine and Center for Molecular Medicine Cologne, University of Cologne, Cologne, Germany
- Mueller, Roman-Ulrich, Department II of Internal Medicine and Center for Molecular Medicine Cologne, University of Cologne, Cologne, Germany
- Burst, Volker Rolf, Department II of Internal Medicine and Center for Molecular Medicine Cologne, University of Cologne, Cologne, Germany
- Grundmann, Franziska, Department II of Internal Medicine and Center for Molecular Medicine Cologne, University of Cologne, Cologne, Germany
Background
Acute kidney injury (AKI) can result in short- and long-term complications and increased mortality. Nonetheless, preventive and therapeutic strategies are lacking. Protein restriction has been shown to protect from organ failure in mice and this protection depended on restriction of sulfur-containing amino acids (SAA).
The UNICORN study aims to evaluate the impact of restricting SAA intake by replacing milk-derived dietary protein by collagen prior to cardiac surgery on AKI.
Methods
In this single-center, randomized, controlled, double-blinded trial 115 patients scheduled for cardiac surgery, were assigned in a 1:1 ratio into a LowS group (SAA depleted formula diet) or a regular formula diet (control group, CG) for 7 days prior to surgery. The primary endpoint was incidence of AKI within 72 hours after surgery (KDIGO), secondary endpoints included increase of serum creatinine at 24h, 48h and 72h as well as safety parameters. Quantitative variables were analyzed with t-test or nonparametric methods, while categorical variables were evaluated by means of Chi-Square or Fisher’s test.
Results
Baseline characteristics: LowS serum creatinine 1.0 mg/dl[0.34] vs. CG 0.85 mg/dl[0.42]; LowS 77% male vs. CG 54%; age: LowS 67y[IQR: 13] vs. CG 69y[12], body weight: LowS 88 kg[20] vs. CG 78kg[18], crossclamp time: LowS 67min[32] vs. CG 68min[35]). Patients in the LowS group had a 77,6% reduction in SAA as compared to CG. There was no difference in the primary endpoint between the groups (LowS AKI incidence 23% vs. CG 16%; p=0.37). Likewise, no differences were observed with respect to secondary endpoints (AKI during hospitalization, creatinine at 24h,48h,72h after surgery). Subgroup analysis focusing on age, gender, body mass index and markers of organ damage did not reveal any between-group differences.
Conclusion
In this first-in-humans translational clinical trial, dietary SAA restriction before cardiac surgery did not result in a lower incidence of AKI. However, larger studies are needed to confirm this finding.
Funding
- Commercial Support –