Effects of allopurinol and vitamin E on renal function in patients with cardiac coronary artery bypass grafts.
BACKGROUND
Acute renal failure is a common complication of cardiac surgery, with oxidants found to play an important role in renal injury. We therefore assessed whether the supplemental antioxidant vitamin E and the inhibitor of xanthine oxidase allopurinol could prevent renal dysfunction after coronary artery bypass graft (CABG) surgery.


METHODS
Of 60 patients with glomerular filtration rate (GFR) < 60 mL/min scheduled to undergo CABG surgery, 30 were randomized to treatment with vitamin E and allopurinol for 3-5 days before surgery and 30 to no treatment. Serum creatinine levels and potassium and creatinine clearances were measured preoperatively and daily until day 5 after surgery.


RESULTS
The patients consisted of 31 males and 29 females, with a mean age of 63 +/- 9 years. After surgery, there were no significant differences in mean serum creatinine (1.2 +/- 0.33 vs 1.2 +/- 0.4 mg/dL; p = 0.43) concentrations, or creatinine clearance (52 +/- 12.8 vs 52 +/- 12.8 mL/min; p = 0.9). The frequency of acute renal failure did not differ in treatment group compared with control (16% vs 13%; p = 0.5). Length of stay in the intensive care unit (ICU) was significantly longer in the control than in the treated group (3.9 +/- 1.5 vs 2.6 +/- 0.7 days; p < 0.001).


CONCLUSIONS
Prophylactic treatment with vitamin E and allopurinol had no renoprotective effects in patients with pre-existing renal failure undergoing CABG surgery. Treatment with these agents, however, reduces the duration of ICU stay.
Nouri-Majalan
Nader
N
Department of Nephrology, Shahid Sadoughi Medical University, Yazd, Iran. dr_nori_majelan@yahoo.com
Ardakani
Ehsan Fotouhi
EF
Forouzannia
Khalil
K
Moshtaghian
Hosein
H
D058186:Acute Kidney Injury / Q000209:etiology / Q000517:prevention & control*; D000368:Aged; D000493:Allopurinol / Q000494:pharmacology*; D000963:Antimetabolites / Q000494:pharmacology*; D000975:Antioxidants / Q000494:pharmacology*; D001026:Coronary Artery Bypass / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007668:Kidney / Q000187:drug effects; D007677:Kidney Function Tests; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D014810:Vitamin E / Q000494:pharmacology*
D000963:Antimetabolites; D000975:Antioxidants; D014810:Vitamin E; D000493:Allopurinol