@entity4388 and Renal Function after Cardiac Surgery: A Prospectively Planned Individual XXXX Meta-analysis.

@entity1 @entity4388 @entity3157 @entity810 @entity1011 @entity2827
BACKGROUND:: The effect of urinary alkalinization in cardiac surgery @entity1 at risk of @entity810 ( @entity810 ) is controversial and trial findings conflicting. Accordingly, the authors performed a prospectively planned individual @entity1 data meta-analysis of the double-blind randomized trials in this field. METHODS:: The authors studied 877 @entity1 from three double-blind, randomized controlled trials enrolled to receive either 24 h of intravenous infusion of @entity4388 or @entity2827 . The primary outcome measure was a postoperative increase in serum @entity1011 concentration of greater than 25% or 0.5 mg/dl (> 44  M/L) within the first five postoperative days. Secondary outcomes included the raw change in serum @entity1011 , greater than 50% and greater than 100% rises in serum @entity1011 , developing @entity810 ( @entity810 ), initiation of renal replacement therapy, morbidity, and mortality. RESULTS:: @entity1 were similar in demographics, comorbidities, and cardiac procedures. @entity4388 increased plasma @entity3157 (P < 0.001) and urine pH (P < 0.001). There were no differences in the development of the primary outcome ( @entity3157 45% [39-51%] vs. Saline 42% [36-48%], P = 0.29). This result remained unchanged when controlling for study and covariates (odds ratio [OR], 99% confidence interval [CI]: @entity3157 vs. Control, 1.11 [0.77-1.60], P = 0.45). There was, however, a significant study-adjusted benefit in elective coronary artery bypass surgery @entity1 in terms of renal replacement therapy ( @entity3157 vs. Control, OR: 0.38 [99% CI: 0.25-0.58], P < 0.0001) and the development of an @entity810 Network grade = 3 ( @entity3157 vs. Control, OR: 0.45 [99% CI: 0.43-0.48], P < 0.0001). CONCLUSIONS:: Urinary alkalinization using @entity4388 infusion is not associated with an overall lower incidence of @entity810 ; however, it reduces severe @entity810 and need for renal replacement therapy in elective coronary artery bypass @entity1 .
