Acute kidney injury (AKI) is reported in up to 30% of patients undergoing cardiac surgery and is a recognized independent predictor of both morbidity and mortality. The use of RenalGuard Therapy to reduce this incidence is being explored. A preliminary study1 published in the British Journal of Cardiology in 2017 used RenalGuard in 10 patients on cardiac pulmonary bypass undergoing cardiac surgery.
Acute kidney injury is the most common major complication of cardiac surgery, with an incidence rate ranging from 5-42% for the more than 2 million cardiac surgeries performed worldwide each year. AKI complicates patient recovery, adds significantly to recovery time and the cost of care, and places patients at an increased risk of death that can remain high for as long as 10 years after surgery even in those who recover full renal function. To date, no preventive strategies have been shown in clinical trials to reduce the occurrence of cardiac surgery-associated AKI.
In the pilot study, The RenalGuard system functioned successfully in all patients and facilitated high perioperative urine outputs, even when patients were placed on cardiopulmonary bypass (CPB). There were no incidences of significant (A) electrolyte imbalance, (B) changes in hemoglobin levels or (C) pulmonary edema. No patients developed AKI within 36 hours of surgery despite one patient developing cardiac tamponade 8 hours postoperatively and one patient developing paralytic ileus. The median intensive care stay was 1.5 (1, 5) days.
The authors concluded the RenalGuard system can be used successfully in patients undergoing cardiac surgery with CPB and may reduce the incidence of AKI in at-risk patients. More investigation is required.
1 Luckraz, H., The use of the RenalGuard system in cardiac surgery with cardiopulmonary bypass: a first in man prospective, observational, feasibility pilot study. openheart, 10 October 2017; Volume 2, Issue 4