title: Effect of erythropoietin on the incidence of acute kidney injury following complex valvular heart surgery: a double blind, randomized clinical trial of efficacy and safety.
abstract: BACKGROUND
  Recombinant human erythropoietin (EPO) is known to provide organ protection against ischemia-reperfusion injury through its pleiotropic properties. The aim of this single-site, randomized, case-controlled, and double-blind study was to investigate the effect of pre-emptive EPO administration on the incidence of postoperative acute kidney injury (AKI) in patients with risk factors for AKI undergoing complex valvular heart surgery.
  
  
  METHODS
  We studied ninety-eight patients with preoperative risk factors for AKI. The patients were randomly allocated to either the EPO group (n = 49) or the control group (n = 49). The EPO group received 300 IU/kg of EPO intravenously after anesthetic induction. The control group received an equivalent volume of normal saline. AKI was defined as an increase in serum creatinine >0.3 mg/dl or >50% from baseline. Biomarkers of renal injury were serially measured until five days postoperatively.
  
  
  RESULTS
  Patient characteristics and operative data, including the duration of cardiopulmonary bypass, were similar between the two groups. Incidence of postoperative AKI (32.7% versus 34.7%, P = 0.831) and biomarkers of renal injury including cystatin C and neutrophil gelatinase-associated lipocalin showed no significant differences between the groups. The postoperative increase in interleukin-6 and myeloperoxidase was similar between the groups. None of the patients developed adverse complications related to EPO administration, including thromboembolic events, throughout the study period.
  
  
  CONCLUSIONS
  Intravenous administration of 300 IU/kg of EPO did not provide renal protection in patients who are at increased risk of developing AKI after undergoing complex valvular heart surgery.
  
  
  BACKGROUND
  Clinical Trial.gov, NCT01758861.
authors.forename: Ji-Ho
authors.initials: JH
authors.lastname: Kim
authors.forename: Jae-Kwang
authors.initials: JK
authors.lastname: Shim
authors.forename: Jong-Wook
authors.initials: JW
authors.lastname: Song
authors.forename: Young
authors.initials: Y
authors.lastname: Song
authors.forename: Hye-Bin
authors.initials: HB
authors.lastname: Kim
authors.forename: Young-Lan
authors.initials: YL
authors.lastname: Kwak
mesh_terms: D058186:Acute Kidney Injury / Q000453:epidemiology / Q000517:prevention & control*; D015415:Biomarkers / Q000097:blood; D002315:Cardiopulmonary Bypass; D016022:Case-Control Studies; D004311:Double-Blind Method; D000068817:Epoetin Alfa; D004921:Erythropoietin / Q000627:therapeutic use*; D005260:Female; D006349:Heart Valve Diseases / Q000601:surgery*; D006397:Hematinics / Q000627:therapeutic use*; D006400:Hematocrit; D006801:Humans; D015994:Incidence; D007677:Kidney Function Tests; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology / Q000517:prevention & control*; D011994:Recombinant Proteins / Q000627:therapeutic use; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D006397:Hematinics; D011994:Recombinant Proteins; D004921:Erythropoietin; D000068817:Epoetin Alfa