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THE JOURNAL OF CARDIOVASCULAR SURGERY
Rivista di Chirurgia Cardiaca, Vascolare e Toracica
Indexed/Abstracted in: BIOSIS Previews, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
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ORIGINAL ARTICLES VASCULAR SECTION
The Journal of Cardiovascular Surgery 2002 August;43(4):483-8
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.