N Engl J Med

Does an amino acid infusion before cardiac surgery protect against kidney injury?

June 17, 2024

Among adult patients undergoing cardiac surgery, infusion of amino acids reduced the occurrence of acute kidney injury (AKI).

• In the multinational, double-blind PROTECTION trial, 3,511 cardiac surgery patients were assigned to either an amino acid group (n=1,759) or a placebo group (n=31.7%). The amino acid group received an IV infusion of a balanced mixture of amino acids at a dose of 2 g/kg of ideal body weight/day. Primary outcome was occurrence of AKI. Secondary outcomes included severity of AKI, use and duration of kidney-replacement therapy, and all-cause 30-day mortality.
• AKI occurred in 26.9% of patients in the amino acid group vs. 31.7% of patients in the placebo group. Stage 3 AKI occurred in 1.6% patients and 3% patients, respectively (relative risk, 0.56; 95% CI, 0.35 to 0.87). Rates of kidney-replacement therapy use were 1.4% and 1.9% in the amino acid and placebo groups, respectively.
• There were no substantial between-differences in other secondary outcomes or in adverse events.

Source:

Landoni G; PROTECTION Study Group. (2024, June 12). N Engl J Med. A Randomized Trial of Intravenous Amino Acids for Kidney Protection. https://pubmed.ncbi.nlm.nih.gov/38865168/