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A Journal on Cardiac, Vascular and Thoracic Surgery

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The Journal of Cardiovascular Surgery 2002 August;43(4):483-8

language: English

Can renal dysfunction after infra-renal aortic aneurysm repair be modified by multi-antioxidant supplementation?

Wijnen M. H. W. A. 1, Vader H. L. 2, Van Den Wall Bake A. W. L. 3, Roumen R. M. H. 1

1 Department of Surgery
2 Clinical Laboratory and
3 Internal Medicine, Saint Joseph Hospital Veldhoven, The Netherlands


Back­ground. ­Renal ­failure ­after ­lower ­torso ­ischemia is a ­serious ­problem, ­partly ­caused by hypo­ten­sion and indi­rect reper­fu­sion ­injury. ­This ­injury is ­partly due to the for­ma­tion of ­oxygen ­free rad­i­cals by acti­vated neu­trophils. ­This ­injury ­results in albu­mi­nuria and ­renal func­tion impair­ment. ­There are indi­ca­tions ­that ­free rad­ical ­damage in indi­rect reper­fu­sion ­injury can be dimin­ished by admin­is­tering ­extra anti­ox­i­dants ­before and ­during reper­fu­sion.
­Methods. In ­this pros­pec­tive ran­dom­ised ­study we ­have ­looked at the influ­ence of a mul­ti­-anti­ox­i­dant sup­ple­men­ta­tion on ­renal func­tion in ­patients under­going an elec­tive ­open infra­renal abdom­inal aneu­rysm ­repair. The ­patients ­received ­either stan­dard treat­ment (n=22) or stan­dard treat­ment ­with addi­tional anti­ox­i­dants per­i­op­er­a­tively (Allo­pu­rinol, ­vitamin E and C, N-ace­tyl­cys­teine and man­nitol). For ­renal func­tion we ­have ­looked at the ­albumin/crea­tinin ­ratio in ­urine and 24 hr crea­tinin clear­ance.
­Results. ­Despite sig­nif­i­cantly ­increased ­serum ­total anti­ox­i­dant ­capacity, the ­group ­receiving ­extra anti­ox­i­dants ­showed no ­decrease in the ­albumin/crea­tinine ­ratio in ­urine. ­There was how­ever a sig­nif­i­cantly ­higher crea­tinin clear­ance in ­this ­group at day 2.
Con­clu­sions. The ­results indi­cate ­that the dimin­ished ­renal func­tion ­after infra­renal aneu­rysm ­repair may be influ­enced by anti­ox­i­dant ­therapy.

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