OBJECTIVE

To evaluate nephroprotective effect of balanced amino acid infusion in patients with intact kidney function undergoing cardiac surgery with cardiopulmonary bypass (CPB).

MATERIAL AND METHODS

The study included 128 patients divided into two groups: the intervention group (n=64) and the control group (n=64). In the intervention group, a balanced amino acid solution (Aminoven 10%, Fresenius Kabi, Austria) was administered at a dose of 2 g/kg/day immediately after anesthesia induction and for the first 24 hours postoperatively. The control group received placebo infusion (a balanced crystalloid solution — Sterofundin, 20 ml/kg/day, B. Braun, Germany) under identical conditions. Statistical analysis of data was performed in Python 3.12 environment.

RESULTS

There were significant differences in estimated glomerular filtration rates (eGFR) (92 [84.1; 100.3] vs. 82.6 [72.4; 92.1], p=0.0011) and creatinine clearance (106.1 [94.8; 118.3] vs. 94.1 [82.9; 105.6], p=0.001). There was less incidence of acute kidney injury (AKI) in the intervention group (12.5% vs. 23.4%) (although this difference was not significance (p=0.166)), as well as shorter duration of injury (3 [3; 3] vs. 5 [4; 5.75] days, p=0.002). Additionally, AKI was less severe in the intervention group and required lower doses of loop diuretics. Analysis of blood urea levels confirmed safety of amino acid infusion.

CONCLUSION

Infusion of a balanced amino acid mixture has a positive impact on kidney function parameters, incidence and duration of AKI in patients with intact kidney function. This intervention is safe and does not affect nitrogen balance.