Author Interviews, Critical Care - Intensive Care - ICUs, Heart Disease, Kidney Disease, NEJM / 13.06.2024
NEJM: Perioperative Amino Acid Infusion Reduced Acute Kidney Injury after Cardiac Surgery
MedicalResearch.com Interview with:
[caption id="attachment_61951" align="alignleft" width="150"] Prof. Landoni[/caption]
Prof Giovanni Landoni, MD
Associate Professor
Università Vita-Salute San Raffaele
Milan, Italy
MedicalResearch.com: What is the background for this study?
Response: Acute kidney injury (AKI) affects approximately 10-15% of hospitalized patients, and up to 50% of intensive care unit (ICU) patients.
In cardiac surgery one patient out of three will face AKI during the postoperative period, and this will lead to higher morbidity and mortality. AKI is associated with an elevated risk of chronic kidney disease, as well as, in the most severe cases, with the use of renal replacement therapy, which may double hospitalization costs, reduce quality of life, and increase long-term mortality. So far, no preventive measure with level I of evidence did exist for AKI.
The PROTECTION trial is a multinational, randomized, double-blind, placebo-controlled trial, conducted at 22 centers in 3 different countries. We recruited 3,511 adult patients undergoing cardiac surgery with cardiopulmonary bypass to receive an intravenous infusion of amino acids (AA) (Isopuramin 10%, Baxter), at 2g/kg/day up to a maximum 100g/day, or an equivalent dose of placebo (Ringer’s solution), for a maximum of 72 hours.
The primary outcome was the incidence of any stage of AKI, according to the Kidney Disease: Improving Global Outcomes (KDIGO) 2012 creatinine criteria.
Prof. Landoni[/caption]
Prof Giovanni Landoni, MD
Associate Professor
Università Vita-Salute San Raffaele
Milan, Italy
MedicalResearch.com: What is the background for this study?
Response: Acute kidney injury (AKI) affects approximately 10-15% of hospitalized patients, and up to 50% of intensive care unit (ICU) patients.
In cardiac surgery one patient out of three will face AKI during the postoperative period, and this will lead to higher morbidity and mortality. AKI is associated with an elevated risk of chronic kidney disease, as well as, in the most severe cases, with the use of renal replacement therapy, which may double hospitalization costs, reduce quality of life, and increase long-term mortality. So far, no preventive measure with level I of evidence did exist for AKI.
The PROTECTION trial is a multinational, randomized, double-blind, placebo-controlled trial, conducted at 22 centers in 3 different countries. We recruited 3,511 adult patients undergoing cardiac surgery with cardiopulmonary bypass to receive an intravenous infusion of amino acids (AA) (Isopuramin 10%, Baxter), at 2g/kg/day up to a maximum 100g/day, or an equivalent dose of placebo (Ringer’s solution), for a maximum of 72 hours.
The primary outcome was the incidence of any stage of AKI, according to the Kidney Disease: Improving Global Outcomes (KDIGO) 2012 creatinine criteria.
Dr. Kosinski[/caption]
Dr. Larry Kosinski, MD
Gastroenterologist and 
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Dr. Haigh[/caption]
Cathryn Haigh, Ph.D.
Dr. Guasch-Ferré[/caption]
Marta Guasch-Ferré, PhD
Associate Professor and Deputy Head of Section, Section of Epidemiology
University of Copenhagen
Group Leader, Novo Nordisk Foundation Center for Basic Metabolic Research
Adjunct Associate Professor, Department of Nutrition
Harvard TH Chan School of Public Health
MedicalResearch.com: What is the background for this study?
Response: Olive oil is rich in monounsaturated fats and contains compounds with antioxidant activity that may play a protective role for the brain. Olive oil as part of a Mediterranean diet appears to have a beneficial effect against cognitive decline. Higher olive oil intake was previously associated with a lower risk of cardiovascular disease and mortality. But its association with dementia mortality was unknown.
Prof. Mainelis[/caption]
Gediminas "Gedi" Mainelis, Ph.D.
Professor, Department of Environmental Sciences
School of Environmental and Biological Sciences
Rutgers, The State University of New Jersey
MedicalResearch.com: What is the background for this study? What types of particles, ie where do they come from?
Response: This work is a continuation of my research on nanoparticles in consumer products. We have investigated and published on the release of particles from nano-enabled consumer products, such as cosmetic powders, various sprays and clothing.
In this project, we were interested in potential resuspension of particles once nano-enabled consumer sprays are used. The particles are added into consumer products to provide them certain desired properties, like antimicrobial protection, odor reduction or protection against UV (sunscreen). Once the products are used, the particles are released and we could be exposed to them.
Dr. Li Gan[/caption]
Dr. Li Gan PhD
Burton P. and Judith B. Resnick Distinguished Professor in Neurodegenerative Diseases
Brain and Mind Research Institute
Weill Cornell Medical College
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