Table of Contents Author Guidelines Submit a Manuscript
Anesthesiology Research and Practice
Volume 2013, Article ID 467326, 8 pages
http://dx.doi.org/10.1155/2013/467326
Research Article

Bicarbonates for the Prevention of Postoperative Renal Failure in Endovascular Aortic Aneurysm Repair: A Randomized Pilot Trial

1Anesthesiology Department, University of Montreal Hospital Centre, 3840 St. Urbain Street, Montréal, QC, Canada H2W 1T8
2Department of Anesthesiology, Maisonneuve-Rosemont Hospital, 5415 Boulevard de l’Assomption, Montréal, QC, Canada H1T 2M4
3Nephrology Department and Guy-Bernier Research Centre, Maisonneuve-Rosemont Hospital, Canada
4Vascular Surgery Department, University of Montreal Hospital Centre, 3840 St. Urbain Street, Montréal, QC, Canada H2W 1T8
5Radiology Department, University of Montreal Hospital Centre, 3840 St. Urbain Street, Montréal, QC, Canada H2W 1T8
6Department of Pharmacology, University of Montreal, 3840 St. Urbain Street, Montréal, QC, Canada H2W 1T8

Received 12 February 2013; Revised 26 April 2013; Accepted 21 May 2013

Academic Editor: Peter Andrews

Copyright © 2013 Véronique Brulotte et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose. Contrast-induced nephropathy (CIN) can contribute to acute kidney injury (AKI) in patients undergoing endovascular aortic aneurysm surgery. We evaluated the incidence of AKI together with the evolution of early biomarkers of renal injury in patients receiving bicarbonates or NaCl 0.9%. Methods. This study involved endovascular aortic aneurysm surgery patients. Group A ( ) received bicarbonates 3 mL/kg/h for 1 h before the procedure and then 1 mL/kg/h until 6 h after surgery, whereas group B ( ) received NaCl 0.9% using the same protocol. Biomarkers of renal injury from urine (interleukin-18 (IL-18), neutrophil gelatinase-associated lipocalin (NGAL), N-acetyl- -D-glucosaminidase (NAG), and kidney injury molecule 1 (KIM-1)) and blood (NGAL, cystatin C) were measured at baseline and 3, 24, and 48 h postoperatively. Results. AKI occurred in 1 patient (2.9%), in the bicarbonates group. IL-18, NAG, NGAL, and KIM-1 significantly rose in both groups after the surgery. There was a greater rise in NGAL and IL-18 after 3 h in the bicarbonates versus NaCl 0.9% group: 1115% versus 240% increase ( ) and 338% increase versus 1.4% decrease ( ). Conclusions. Despite significant elevation in biomarkers of renal injury, we demonstrated a low rate of AKI following endovascular aortic surgery.