Restrictive versus liberal fluid therapy for post-cesarean acute kidney injury in severe preeclampsia: a pilot randomized clinical trial
Clinics
; 75: e1797, 2020. tab, graf
Article
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| ID: biblio-1133410
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ABSTRACT
OBJECTIVES:
The aim of this study was to determine whether a restrictive compared to a liberal fluid therapy will increase postoperative acute kidney injury (AKI) in patients with severe preeclampsia.METHODS:
A total of 46 patients (mean age, 32 years; standard deviation, 6.8 years) with severe preeclampsia were randomized to liberal (1500 ml of lactated Ringer's, n=23) or restrictive (250 ml of lactated Ringer's, n=23) intravenous fluid regimen during cesarean section. The primary outcome was the development of a postoperative renal dysfunction defined by AKI Network stage ≥1. Serum cystatin C and neutrophil gelatinase-associated lipocalin (NGAL) were evaluated at postoperative days 1 and 2. ClinicalTrials.gov NCT02214186.RESULTS:
The rate of postoperative AKI was 43.5% in the liberal fluid group and 43.5% in the restrictive fluid group (p=1.0). Intraoperative urine output was higher in the liberal (116 ml/h, IQR 69-191) than in the restrictive fluid group (80 ml/h, IQR 37-110, p<0.05). In both groups, serum cystatin C did not change from postoperative day 1 compared to the preoperative period and significantly decreased on postoperative day 2 compared to postoperative day 1 (p<0.05). In the restrictive fluid group, NGAL levels increased on postoperative day 1 compared to the preoperative period (p<0.05) and decreased on postoperative day 2 compared to postoperative day 1 (p<0.05).CONCLUSION:
Among patients with severe preeclampsia, a restrictive fluid regimen during cesarean section was not associated with increased postoperative AKI.
Texte intégral:
1
Indice:
LILACS
Sujet Principal:
Pré-éclampsie
/
Atteinte rénale aigüe
Type d'étude:
Clinical_trials
Limites du sujet:
Adult
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Female
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Humans
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Pregnancy
langue:
En
Texte intégral:
Clinics
Thème du journal:
MEDICINA
Année:
2020
Type:
Article