title: Acute kidney injury after cardiac surgery: is minocycline protective?
abstract: OBJECTIVE
  Acute kidney injury (AKI) after cardiac bypass surgery (CABG) is common and carries a significant association with morbidity and mortality. Since minocycline therapy attenuates kidney injury in animal models of AKI, we tested its effects in patients undergoing CABG.
  
  
  METHODS
  This is a randomized, double-blinded, placebo-controlled, multi-center study. We screened high risk patients who were scheduled to undergo CABG in two medical centers between Jan 2008 and June 2011. 40 patients were randomized and 19 patients in each group completed the study. Minocycline prophylaxis was given twice daily, at least for four doses prior to CABG. Primary outcome was defined as AKI [0.3 mg/dl increase in creatinine (Cr)] within 5 days after surgery. Daily serum Cr for 5 days, various clinical and hemodynamic measures and length of stay were recorded.
  
  
  RESULTS
  The two groups had similar baseline and intra-operative characteristics. The primary outcome occurred in 52.6% of patients in the minocycline group as compared to 36.8% of patients in the placebo group (p = 0.51). Peak Cr was 1.6 ± 0.7 vs. 1.5 ± 0.7 mg/dl (p = 0.45) in minocycline and placebo groups, respectively. Death at 30 days occurred in 0 vs. 10.5% in the minocycline and placebo groups, respectively (p = 0.48). There were no differences in post-operative length of stay, and cardiovascular events between the two groups. There was a trend towards lower diastolic pulmonary artery pressure [16.8 ± 4.7 vs. 20.7 ± 6.6 mmHg (p = 0.059)] and central venous pressure [11.8 ± 4.3 vs. 14.6 ± 5.6 mmHg (p = 0.13)] in the minocycline group compared to placebo on the first day after surgery.
  
  
  CONCLUSIONS
  Minocycline did not protect against AKI post-CABG.
authors.affiliation: Montefiore Medical Center, Albert Einstein Medical Center, 3411 Wayne Ave, Suite 5H, Bronx, NY, 10467, USA, lgolesta@montefiore.org.
authors.forename: Ladan
authors.initials: L
authors.lastname: Golestaneh
authors.forename: Kathryn
authors.initials: K
authors.lastname: Lindsey
authors.forename: Pooja
authors.initials: P
authors.lastname: Malhotra
authors.forename: Faraj
authors.initials: F
authors.lastname: Kargoli
authors.forename: Emily
authors.initials: E
authors.lastname: Farkas
authors.forename: Hendrick
authors.initials: H
authors.lastname: Barner
authors.forename: Rizwan
authors.initials: R
authors.lastname: Qazi
authors.forename: Anna
authors.initials: A
authors.lastname: Schmidt
authors.forename: Michael
authors.initials: M
authors.lastname: Rauchman
authors.forename: Ziyad
authors.initials: Z
authors.lastname: Al-Aly
authors.forename: Robert
authors.initials: R
authors.lastname: Johnson
authors.forename: Kevin
authors.initials: K
authors.lastname: Martin
authors.forename: Pierre
authors.initials: P
authors.lastname: Dagher
authors.forename: Allon
authors.initials: A
authors.lastname: Friedman
authors.forename: Tarek M
authors.initials: TM
authors.lastname: El-Achkar
mesh_terms: D058186:Acute Kidney Injury / Q000097:blood / Q000209:etiology / Q000517:prevention & control*; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D062186:Arterial Pressure / Q000187:drug effects; D002496:Central Venous Pressure / Q000187:drug effects; D001026:Coronary Artery Bypass / Q000009:adverse effects* / Q000401:mortality; D003404:Creatinine / Q000097:blood; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D008911:Minocycline / Q000627:therapeutic use*; D010865:Pilot Projects
chemical_list: D000900:Anti-Bacterial Agents; D003404:Creatinine; D008911:Minocycline