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The practice of kidney transplantation enhances the quality of life and improves the rates of survivance in patients with chronical renal diseases. In the case of a kidney transplant with a living donor, different mechanisms are being sought to improve residual renal function. Preclinical studies have identified the upregulation of NAD+ as a potential strategy for the prevention and treatment of AKI (acute kidney injury). NAD+ is the final metabolized form of vitamin B3. A recent clinical study found that COVID-19-related AKI was associated with NAD+ biosynthetic impairment arising in the context of ischemic, inflammatory, or toxic kidney injury.
Given the unavailability of vitamin B3 in the country, our objective was to determine if I.V. vitamin B complex (vitamin B1, B6 and B12) could improve renal recovery in living donors kidney. By oxidation, vitamin B6 through the pentose phosphate pathways leads to the formation of NADPH (nicotinamide adenine phosphate dinucleotide) an analog of NAD+. (VIBAKY Trial)
A randomized, blinded, placebo-controlled study was performed on living donors kidney. During the study I.V. vitamin B complex or placebo was administered twice daily for 7 consecutive days before and after nephrectomy. Serum creatinine (sCr) was measured using Mindray BS240 PRO automated equipment. We evaluated whether vitamin B complex could improve kidney recovery in residual renal function.
The ratio between the use of complex B and the different categorical variables considered in the analysis was evaluated using the χ2 test of independence or Fisher's exact test in the case of reduced frequencies in the contingency tables. The value considered as the threshold for rejection of the null hypothesis was 5% (α=0.05). The data was processed in SPSS v. 18 and R v. 4.3.1.
Conclusions
· There is no difference between the baseline or discharge creatinine distributions, according to the use or not of B complex (p>0.05).
· There is a significant increase between baseline creatinine (P50=0.9 mg dL-1) and creatinine at discharge (P50=1.1 mg dL-1), (p<0.05), which is expected according to the literature.
The limitations of the present article are related to the sample size and the follow-up time; we consider that the expected results were not achieved, so the follow-up of this group of patients will be maintained.