Comparative Study between the Effectiveness of N-acetylcysteine and Bicarbonate in Renal Protection after Cardiac Bypass Surgery

Abstract

Cardiac surgery-associated acute kidney injury is a common and serious postoperative complication of cardiac surgery that employs cardiopulmonary bypass. Risk factors for acute kidney injury are common among patients undergoing cardiac surgery. Many of these factors are not modifiable as elevated preoperative serum creatinine. However, some factors may be potentially modifiable. These factors specifically related to the bypass procedure itself. Almost all of that risk factors relate to either impaired renal perfusion or decreased renal reserve. Hemodynamic optimization is the cornerstone for acute kidney injury prevention. Consequently, perioperative hypotension should be avoided and a mean arterial pressure able to guarantee an adequate glomerular capillary filtration pressure. Several other supportive therapies have been proposed such as diuretics, statins, fenoldopam. Some authors believed that the massive release of oxygen free radicals during the early phase of reperfusion is mostly the source for these injuries. So, several agents have been used to minimize that injury. N-acetylcysteine was among these agents