Amino Acid Infusion Reduces Acute Kidney Injury in Cardiac Surgery Patients

Strategic Insights -

In a landmark study, researchers at the Institute for Cancer Research and Treatment (IRCCS) San Raffaele Scientific Institute have found that intravenous amino acid therapy significantly decreases the occurrence of acute kidney injury in cardiac surgery patients, particularly those with chronic kidney disease. This breakthrough research, published in the journal Anesthesiology, highlights the potential of amino acid infusion as a protective measure in reducing kidney damage during cardiac surgery.

Key Takeaways:

  • The PROTECTION trial, a multicenter randomized controlled trial, involved 812 patients with chronic kidney disease undergoing cardiopulmonary bypass surgery.
  • Amino acid infusion reduced the rate of acute kidney injury by 7% (43.1% vs 50.3%) with a relative risk reduction of 14%.
  • The amino acid effect was similar in estimated glomerular filtration rate-based chronic kidney disease subgroups, with a median percentage increase in estimated glomerular filtration rate from baseline to postoperative day 3 of 12.7% versus 6.5% (P = 0.002).
  • Amino acid infusion decreased the occurrence of severe (stage 3) acute kidney injury by 2.3% (2.7% vs 5.6%) with a relative risk reduction of 48%.
  • The study concluded that amino acid infusion protected chronic kidney disease patients undergoing cardiopulmonary bypass from developing acute kidney injury, with an absolute risk reduction of 7% and a number needed to treat of 14.

Statistics:

  • 812 patients with chronic kidney disease were included in the study.
  • Amino acid infusion reduced the rate of acute kidney injury by 7% (43.1% vs 50.3%).
  • The median percentage increase in estimated glomerular filtration rate from baseline to postoperative day 3 for the amino acid group was 12.7%.
  • Amino acid infusion decreased the occurrence of severe (stage 3) acute kidney injury by 2.3% (2.7% vs 5.6%).
  • The number needed to treat with amino acid infusion was 14.

Sources:

  • Amino Acid Infusion for Kidney Protection In Cardiac Surgery Patients With Chronic Kidney Disease: a Secondary Analysis of the Protection Trial. Anesthesiology, 2025;142(5):818-828.
  • Anesthesiology can be contacted at: Lippincott Williams & Wilkins, Two Commerce Sq, 2001 Market St, Philadelphia, PA 19103, USA.