IMPACT OF AMINO ACID/PROTEIN THERAPY ON RENAL OUTCOMES AND RECOVERY IN CARDIAC SURGERY PATIENTS: A SYSTEMATIC REVIEW AND META-ANALYSIS

7 Feb 2025 12 a.m. 12 a.m.
WCN25-AB-3185, Poster Board= FRI-020

Introduction:

Intravenous amino acid therapy is being investigated for kidney protection in high-risk cardiac surgery patients with acute kidney injury (AKI), which leads to higher morbidity and mortality. Although amino acids might improve certain renal outcomes, their impact on the duration of renal dysfunction remains uncertain. This study aimed to clarify the effects of amino acid/protein therapy compared to control on renal outcomes in patients undergoing cardiac surgery.

Methods:

We conducted a systematic search of PubMed, Embase, and Cochrane databases for randomized controlled trials (RCTs) and propensity-matched cohorts (PMC) to evaluate the efficacy of amino acids and/or proteins in reducing the occurrence of AKI after cardiac surgery. The primary outcomes included the incidence of AKI stages 2 and 3, necessity of postoperative kidney replacement therapy (KRT), mortality, ICU stay, and hospital length of stay. Relative risk (RR) was calculated for binary outcomes and standardized mean difference (MD) was calculated for continuous variables, with 95% confidence intervals (CIs). Heterogeneity was assessed using I² statistics.

Results:

A total of 6 RCTs and 1 PMC, involving 5,615 patients (2,751 received protein/amino acids), were included in the analysis. The results showed no significant differences between the groups in terms of AKI stage 2 and 3 (RR 0.95; 95% CI 0.39–2.31; p=0.914; Figure 1A), kidney replacement therapy (RR 0.72; 95% CI 0.45–1.15; p=0.34; Figure 1B), mortality (RR 1.03; 95% CI 0.76–1.29; p=0.863; Figure 1C), or ICU length of stay (SMD -0.05; 95% CI -0.10–0.01; p=0.108; Figure 2A). However, the length of hospital stay was significantly shorter in the amino/protein group (SMD -0.62; 95% CI -1.08– -0.15; p=0.009; Figure 2B).

Figure 1

Conclusions:

Our study suggests that the use of amino acids/protein was associated with a significantly shorter hospitalization time, with no differences in reduction of AKI incidence, KRT or mortality in patients undergoing cardiac surgery. Therefore, the use of amino acids/protein can be considered a viable tool for patients in this context.

I have no potential conflict of interest to disclose.

I did not use generative AI and AI-assisted technologies in the writing process.