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De Bono JA, Conte SM, Newcomb AE. Effects of Preoperative Angiotensin-Converting Enzyme Inhibitor Therapy on Postoperative Renal Function in Cardiac Surgery. Heart Lung Circ 2020; 29:1656-1667. [PMID: 32732124 DOI: 10.1016/j.hlc.2020.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Revised: 04/23/2020] [Accepted: 06/03/2020] [Indexed: 11/19/2022]
Abstract
A Best Evidence Topic in cardiac surgery was written according to a structured protocol. The question addressed was-"In patients who undergo cardiac surgery, is preoperative angiotensin-converting enzyme inhibitor therapy associated with postoperative renal dysfunction?" Altogether, 339 papers were found using the reported search. Ten (10) were chosen which best answered the clinical question. The papers were evaluated for bias and heterogeneity using validated tools and the collected results analysed qualitatively. Evidence in the current literature is inconclusive that preoperative administration of angiotensin-converting enzyme inhibitor therapy affects postoperative renal dysfunction in patients undergoing cardiac surgery.
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Affiliation(s)
- Joshua A De Bono
- Cardiothoracic Unit, St Vincent's Hospital Melbourne, Melbourne, Vic, Australia.
| | - Sean M Conte
- Cardiology Unit, St Vincent's Hospital Sydney, Sydney, NSW, Australia
| | - Andrew E Newcomb
- Cardiothoracic Unit, St Vincent's Hospital Melbourne, Melbourne, Vic, Australia
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Niioka T, Komatsuda A, Kato S, Togashi M, Okuyama S, Omokawa A, Nara M, Wakui H, Takahashi N, Miura M. Effects of CYP3A5 polymorphism and the tacrolimus 12 h concentration on tacrolimus-induced acute renal dysfunction in patients with lupus nephritis. Xenobiotica 2015; 45:1147-53. [PMID: 26189776 DOI: 10.3109/00498254.2015.1045571] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
1. The purpose of the present study was to investigate the effect of tacrolimus concentration in blood 12 h after administration (C12h) on acute renal dysfunction in patients with lupus nephritis (LN) taking tacrolimus once daily. 2. Five of the 35 LN patients experienced tacrolimus-induced acute renal dysfunction. 3. The average annual C12h of tacrolimus was higher for patients with events of elevated serum creatinine level than for patients not experiencing these events [6.4 (5.6-8.8) versus 2.8 (2.2-4.6) ng/mL, respectively, p=0.001]. 4. The average annual tacrolimus C12h was higher for patients with CYP3A5*3/*3 (PM) than for patients with the CYP3A5*1 allele (EM) [4.6 (3.2-6.6) versus 2.5 (2.0-3.1) ng/mL, respectively, p=0.002]. 5. The area under the receiver operating characteristic was 0.887, which gave the best sensitivity (80.0%) and specificity (86.7%) at a tacrolimus C12h (average annual C12h or C12h at events) threshold of 5.2 ng/mL. 6. C12h measurements, CYP3A5 genotyping and dose adjustments of tacrolimus should be performed to prevent acute renal dysfunction in LN patients taking tacrolimus once daily.
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Affiliation(s)
- Takenori Niioka
- a Department of Pharmacy , Akita University Hospital , Akita , Japan
| | - Atsushi Komatsuda
- b Department of Hematology, Nephrology, Rheumatology , Akita University Graduate School of Medicine , Akita , Japan
| | - Shotaro Kato
- a Department of Pharmacy , Akita University Hospital , Akita , Japan
| | - Masaru Togashi
- b Department of Hematology, Nephrology, Rheumatology , Akita University Graduate School of Medicine , Akita , Japan
| | - Shin Okuyama
- c Center for Kidney Disease and Transplantation, Akita University Hospital , Akita , Japan
| | - Ayumi Omokawa
- d Department of General Internal Medicine and Clinical Laboratory Medicine , Akita University Graduate School of Medicine , Akita , Japan , and
| | - Mizuho Nara
- b Department of Hematology, Nephrology, Rheumatology , Akita University Graduate School of Medicine , Akita , Japan
| | - Hideki Wakui
- e Department of Life Science , Graduate School of Engineering and Resource Science, Akita University , Akita , Japan
| | - Naoto Takahashi
- b Department of Hematology, Nephrology, Rheumatology , Akita University Graduate School of Medicine , Akita , Japan
| | - Masatomo Miura
- a Department of Pharmacy , Akita University Hospital , Akita , Japan
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Arora R, Kathuria S, Jalandhara N. Acute renal dysfunction in patients with alcoholic hepatitis. World J Hepatol 2011; 3:121-4. [PMID: 21731905 PMCID: PMC3124879 DOI: 10.4254/wjh.v3.i5.121] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2010] [Revised: 03/06/2011] [Accepted: 03/13/2011] [Indexed: 02/06/2023] Open
Abstract
Acute renal dysfunction is common in patients with alcoholic hepatitis (AH). Its presence leads to higher mortality in these patients. Despite advances in medical care, the outcome has changed little over the past decades. Studies using Pentoxifylline and molecular adsorbent recirculation system have shown encouraging data in small studies. Further larger well designed studies are needed to assess these modalities of treatment for the treatment of AH.
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Affiliation(s)
- Robin Arora
- Robin Arora, Nishant Jalandhara, Division of Nephrology, Department of Internal Medicine, Tulane University, New Orleans, LA 70118, United States
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