Acute kidney injury after cardiac surgery: is minocycline protective?

Ladan Golestaneh, Kathryn Lindsey, Pooja Malhotra, Faraj Kargoli, Emily Farkas, Hendrick Barner, Rizwan Qazi, Anna Schmidt, Michael Rauchman, Ziyad Al-Aly, Robert Johnson, Kevin Martin, Pierre Dagher, Allon Friedman, Tarek Ashkar (El-Achkar)

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Background and objectives: Acute kidney injury (AKI) after cardiac bypass surgery (CABG) is common and carries a significant association with morbidity and mortality. Since minocycline therapy attenuates kidney injury in animal models of AKI, we tested its effects in patients undergoing CABG. Design, setting, participants and measurements: This is a randomized, double-blinded, placebo-controlled, multi-center study. We screened high risk patients who were scheduled to undergo CABG in two medical centers between Jan 2008 and June 2011. 40 patients were randomized and 19 patients in each group completed the study. Minocycline prophylaxis was given twice daily, at least for four doses prior to CABG. Primary outcome was defined as AKI [0.3 mg/dl increase in creatinine (Cr)] within 5 days after surgery. Daily serum Cr for 5 days, various clinical and hemodynamic measures and length of stay were recorded. Results: The two groups had similar baseline and intra-operative characteristics. The primary outcome occurred in 52.6 % of patients in the minocycline group as compared to 36.8 % of patients in the placebo group (p = 0.51). Peak Cr was 1.6 ± 0.7 vs. 1.5 ± 0.7 mg/dl (p = 0.45) in minocycline and placebo groups, respectively. Death at 30 days occurred in 0 vs. 10.5 % in the minocycline and placebo groups, respectively (p = 0.48). There were no differences in post-operative length of stay, and cardiovascular events between the two groups. There was a trend towards lower diastolic pulmonary artery pressure [16.8 ± 4.7 vs. 20.7 ± 6.6 mmHg (p = 0.059)] and central venous pressure [11.8 ± 4.3 vs. 14.6 ± 5.6 mmHg (p = 0.13)] in the minocycline group compared to placebo on the first day after surgery. Conclusions: Minocycline did not protect against AKI post-CABG.

Original languageEnglish (US)
Pages (from-to)193-199
Number of pages7
JournalJournal of Nephrology
Volume28
Issue number2
DOIs
StatePublished - Apr 1 2015

Fingerprint

Minocycline
Acute Kidney Injury
Thoracic Surgery
Placebos
Creatinine
Length of Stay
Central Venous Pressure
Ambulatory Surgical Procedures
Pulmonary Artery
Animal Models
Hemodynamics
Morbidity
Kidney
Pressure
Mortality
Wounds and Injuries
Serum

Keywords

  • Acute kidney injury
  • Cardiac surgery
  • Minocycline

ASJC Scopus subject areas

  • Nephrology

Cite this

Golestaneh, L., Lindsey, K., Malhotra, P., Kargoli, F., Farkas, E., Barner, H., ... Ashkar (El-Achkar), T. (2015). Acute kidney injury after cardiac surgery: is minocycline protective? Journal of Nephrology, 28(2), 193-199. https://doi.org/10.1007/s40620-014-0152-2

Acute kidney injury after cardiac surgery : is minocycline protective? / Golestaneh, Ladan; Lindsey, Kathryn; Malhotra, Pooja; Kargoli, Faraj; Farkas, Emily; Barner, Hendrick; Qazi, Rizwan; Schmidt, Anna; Rauchman, Michael; Al-Aly, Ziyad; Johnson, Robert; Martin, Kevin; Dagher, Pierre; Friedman, Allon; Ashkar (El-Achkar), Tarek.

In: Journal of Nephrology, Vol. 28, No. 2, 01.04.2015, p. 193-199.

Research output: Contribution to journalArticle

Golestaneh, L, Lindsey, K, Malhotra, P, Kargoli, F, Farkas, E, Barner, H, Qazi, R, Schmidt, A, Rauchman, M, Al-Aly, Z, Johnson, R, Martin, K, Dagher, P, Friedman, A & Ashkar (El-Achkar), T 2015, 'Acute kidney injury after cardiac surgery: is minocycline protective?', Journal of Nephrology, vol. 28, no. 2, pp. 193-199. https://doi.org/10.1007/s40620-014-0152-2
Golestaneh L, Lindsey K, Malhotra P, Kargoli F, Farkas E, Barner H et al. Acute kidney injury after cardiac surgery: is minocycline protective? Journal of Nephrology. 2015 Apr 1;28(2):193-199. https://doi.org/10.1007/s40620-014-0152-2
Golestaneh, Ladan ; Lindsey, Kathryn ; Malhotra, Pooja ; Kargoli, Faraj ; Farkas, Emily ; Barner, Hendrick ; Qazi, Rizwan ; Schmidt, Anna ; Rauchman, Michael ; Al-Aly, Ziyad ; Johnson, Robert ; Martin, Kevin ; Dagher, Pierre ; Friedman, Allon ; Ashkar (El-Achkar), Tarek. / Acute kidney injury after cardiac surgery : is minocycline protective?. In: Journal of Nephrology. 2015 ; Vol. 28, No. 2. pp. 193-199.
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AU - Farkas, Emily

AU - Barner, Hendrick

AU - Qazi, Rizwan

AU - Schmidt, Anna

AU - Rauchman, Michael

AU - Al-Aly, Ziyad

AU - Johnson, Robert

AU - Martin, Kevin

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AU - Ashkar (El-Achkar), Tarek

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N2 - Background and objectives: Acute kidney injury (AKI) after cardiac bypass surgery (CABG) is common and carries a significant association with morbidity and mortality. Since minocycline therapy attenuates kidney injury in animal models of AKI, we tested its effects in patients undergoing CABG. Design, setting, participants and measurements: This is a randomized, double-blinded, placebo-controlled, multi-center study. We screened high risk patients who were scheduled to undergo CABG in two medical centers between Jan 2008 and June 2011. 40 patients were randomized and 19 patients in each group completed the study. Minocycline prophylaxis was given twice daily, at least for four doses prior to CABG. Primary outcome was defined as AKI [0.3 mg/dl increase in creatinine (Cr)] within 5 days after surgery. Daily serum Cr for 5 days, various clinical and hemodynamic measures and length of stay were recorded. Results: The two groups had similar baseline and intra-operative characteristics. The primary outcome occurred in 52.6 % of patients in the minocycline group as compared to 36.8 % of patients in the placebo group (p = 0.51). Peak Cr was 1.6 ± 0.7 vs. 1.5 ± 0.7 mg/dl (p = 0.45) in minocycline and placebo groups, respectively. Death at 30 days occurred in 0 vs. 10.5 % in the minocycline and placebo groups, respectively (p = 0.48). There were no differences in post-operative length of stay, and cardiovascular events between the two groups. There was a trend towards lower diastolic pulmonary artery pressure [16.8 ± 4.7 vs. 20.7 ± 6.6 mmHg (p = 0.059)] and central venous pressure [11.8 ± 4.3 vs. 14.6 ± 5.6 mmHg (p = 0.13)] in the minocycline group compared to placebo on the first day after surgery. Conclusions: Minocycline did not protect against AKI post-CABG.

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KW - Acute kidney injury

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