Universität zu Köln

Grundmann, Franziska, Mueller, Roman-Ulrich, Reppenhorst, Annika, Huelswitt, Lennart, Spaeth, Martin R., Kubacki, Torsten, Scherner, Maximilian, Faust, Michael, Becker, Ingrid ORCID: 0000-0001-5829-3553, Wahlers, Thorsten, Schermer, Bernhard ORCID: 0000-0002-5194-9000, Benzing, Thomas and Burst, Volker (2018). Preoperative Short-Term Calorie Restriction for Prevention of Acute Kidney Injury After Cardiac Surgery: A Randomized, Controlled, Open-Label, Pilot Trial. J. Am. Heart Assoc., 7 (6). HOBOKEN: WILEY. ISSN 2047-9980

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Abstract

Background-Acute kidney injury is a frequent complication after cardiac surgery and is associated with adverse outcomes. Although short-term calorie restriction (CR) has proven protective in rodent models of acute kidney injury, similar effects have not yet been demonstrated in humans. Methods and Results-CR_KCH (Effect of a Preoperative Calorie Restriction on Renal Function After Cardiac Surgery) is a randomized controlled trial in patients scheduled for cardiac surgery. Patients were randomly assigned to receive either a formula diet containing 60% of the daily energy requirement (CR group) or adlibitum food (control group) for 7days before surgery. In total, 82 patients were enrolled between April 16, 2012, and February 5, 2015. There was no between-group difference in the primary end point of median serum creatinine increment after 24 hours (control group: 0.0 mg/dL [-0.1 - (+0.2) mg/dL]; CR group: 0.0 mg/dL [-0.2 - (+0.2) mg/dL]; P=0.39). CR prevented a rise in median creatinine at 48 hours (control group: +0.1 mg/dL [0.0 - 0.3 mg/dL]; CR group: -0.1 mg/dL [-0.2 - (+0.1) mg/dL]; P=0.03), with most pronounced effects observed in male patients and patients with a body mass index >25. This benefit persisted until discharge: Median creatinine decreased by 0.1 mg/dL (-0.2 - 0.0 mg/dL) in the CR group, whereas it increased by 0.1 mg/dL (0.0 - 0.3 mg/dL; P=0.0006) in the control group. Incidence of acute kidney injury was reduced by 5.8% (41.7% in the CR group compared with 47.5% in the control group). Safety-related events did not differ between groups. Conclusions-Despite disappointing results with respect to creatinine rise within the first 24 hours, the benefits observed at later time points and the subgroup analyses suggest the protective potential of short-term CR in patients at risk for acute kidney injury, warranting further investigation.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Grundmann, Franziska UNSPECIFIED UNSPECIFIED UNSPECIFIED Mueller, Roman-Ulrich UNSPECIFIED UNSPECIFIED UNSPECIFIED Reppenhorst, Annika UNSPECIFIED UNSPECIFIED UNSPECIFIED Huelswitt, Lennart UNSPECIFIED UNSPECIFIED UNSPECIFIED Spaeth, Martin R. UNSPECIFIED UNSPECIFIED UNSPECIFIED Kubacki, Torsten UNSPECIFIED UNSPECIFIED UNSPECIFIED Scherner, Maximilian UNSPECIFIED UNSPECIFIED UNSPECIFIED Faust, Michael UNSPECIFIED UNSPECIFIED UNSPECIFIED Becker, Ingrid UNSPECIFIED orcid.org/0000-0001-5829-3553 UNSPECIFIED Wahlers, Thorsten UNSPECIFIED UNSPECIFIED UNSPECIFIED Schermer, Bernhard UNSPECIFIED orcid.org/0000-0002-5194-9000 UNSPECIFIED Benzing, Thomas UNSPECIFIED UNSPECIFIED UNSPECIFIED Burst, Volker UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-192576
DOI:	10.1161/JAHA.117.008181
Journal or Publication Title:	J. Am. Heart Assoc.
Volume:	7
Number:	6
Date:	2018
Publisher:	WILEY
Place of Publication:	HOBOKEN
ISSN:	2047-9980
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language ISCHEMIA-REPERFUSION INJURY; DIETARY RESTRICTION; LIFE-SPAN; MORTALITY Multiple languages Cardiac & Cardiovascular Systems Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/19257