Randomized clinical trial of the effects of methylprednisolone on renal function after major vascular surgery
Background: Perioperative renal dysfunction following abdominal aortic aneurysm (AAA) repair is multifactorial and may involve hypotension, hypoxia and ischaemia–reperfusion injury. Studies of cardiac and hepatic transplant surgery have demonstrated beneficial effects on renal function of high‐dose...
Gespeichert in:
| Veröffentlicht in: | British journal of surgery 2008-01, Vol.95 (1), p.50-56 |
|---|---|
| Hauptverfasser: | , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 56 |
|---|---|
| container_issue | 1 |
| container_start_page | 50 |
| container_title | British journal of surgery |
| container_volume | 95 |
| creator | Turner, S. Derham, C. Orsi, N. M. Bosomworth, M. Bellamy, M. C. Howell, S. J. |
| description | Background:
Perioperative renal dysfunction following abdominal aortic aneurysm (AAA) repair is multifactorial and may involve hypotension, hypoxia and ischaemia–reperfusion injury. Studies of cardiac and hepatic transplant surgery have demonstrated beneficial effects on renal function of high‐dose methylprednisolone administered before surgery.
Methods:
Twenty patients undergoing elective open AAA repair were randomized to receive either methylprednisolone 10 mg/kg or dextrose (control) before induction of anaesthesia. Blood was analysed for a panel of cytokines representative of T helper cell type 1 and 2 subsets. Urine was analysed for subclinical markers of renal dysfunction (albumin, α1‐microglobulin and N‐acetyl‐β‐D‐glucosaminidase).
Results:
Data from 18 patients were analysed. Both groups demonstrated glomerular and proximal convoluted tubular dysfunction that was unaffected by steroid treatment. Steroid administration increased serum levels of urea and creatinine (both P < 0·001). The steroid group had increased interleukin 10 levels (P = 0·005 compared to controls). There were no differences between groups in overall surgical complications, length of intensive care unit (P = 0·821) and hospital (P = 0·719) stay, or 30‐day mortality.
Conclusion:
Methylprednisolone administration altered the cytokine profile favourably but adversely affected postoperative renal function. Copyright © 2007 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
Harmful to the kidneys |
| doi_str_mv | 10.1002/bjs.5978 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_proquest_miscellaneous_70185449</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>70185449</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3888-e1598e8284a5ba07365ddf0d066aba7dfdc42a3740765e891524153d25f9033c3</originalsourceid><addsrcrecordid>eNpF0U1vEzEQBmALgWhakPgFyBe4bfHHeu09QgoFFIGgIBAXy7HH1MHrDfZuIfx6HDWQy4xGfjTS-EXoESXnlBD2bL0p56KX6g5aUN6JhtFO3UULQohsKGf8BJ2WsiGEciLYfXRCFWGSK75Aw0eT3DiEP-CwjSEFayKecqh19Hi6Bgzeg53Kfhxgut7FbQaXQhnjmACPCWdIVfs52SnU0fgJMh7MZsz4xhQ7R5NxmfN3yLsH6J43scDDQz9Dn1-9_LR83azeX75ZPl81liulGqCiV6CYao1YGyLrSc554kjXmbWRzjvbMsNlS2QnQPVUsJYK7pjwPeHc8jP09HbvNo8_ZyiTHkKxEKNJMM5FS0KVaNu-wscHOK8HcHqbw2DyTv_7oAqeHEA9xUSfTbKhHF3fK961tLrm1v0KEXbHd6L3AekakN4HpF-8vdr3ow9lgt__vck_dCe5FPrLu0stv3Yfllerb_qC_wWkVZJa</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>70185449</pqid></control><display><type>article</type><title>Randomized clinical trial of the effects of methylprednisolone on renal function after major vascular surgery</title><source>MEDLINE</source><source>Access via Wiley Online Library</source><source>Oxford University Press Journals All Titles (1996-Current)</source><creator>Turner, S. ; Derham, C. ; Orsi, N. M. ; Bosomworth, M. ; Bellamy, M. C. ; Howell, S. J.</creator><creatorcontrib>Turner, S. ; Derham, C. ; Orsi, N. M. ; Bosomworth, M. ; Bellamy, M. C. ; Howell, S. J.</creatorcontrib><description>Background:
Perioperative renal dysfunction following abdominal aortic aneurysm (AAA) repair is multifactorial and may involve hypotension, hypoxia and ischaemia–reperfusion injury. Studies of cardiac and hepatic transplant surgery have demonstrated beneficial effects on renal function of high‐dose methylprednisolone administered before surgery.
Methods:
Twenty patients undergoing elective open AAA repair were randomized to receive either methylprednisolone 10 mg/kg or dextrose (control) before induction of anaesthesia. Blood was analysed for a panel of cytokines representative of T helper cell type 1 and 2 subsets. Urine was analysed for subclinical markers of renal dysfunction (albumin, α1‐microglobulin and N‐acetyl‐β‐D‐glucosaminidase).
Results:
Data from 18 patients were analysed. Both groups demonstrated glomerular and proximal convoluted tubular dysfunction that was unaffected by steroid treatment. Steroid administration increased serum levels of urea and creatinine (both P < 0·001). The steroid group had increased interleukin 10 levels (P = 0·005 compared to controls). There were no differences between groups in overall surgical complications, length of intensive care unit (P = 0·821) and hospital (P = 0·719) stay, or 30‐day mortality.
Conclusion:
Methylprednisolone administration altered the cytokine profile favourably but adversely affected postoperative renal function. Copyright © 2007 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
Harmful to the kidneys</description><identifier>ISSN: 0007-1323</identifier><identifier>EISSN: 1365-2168</identifier><identifier>DOI: 10.1002/bjs.5978</identifier><identifier>PMID: 18027383</identifier><identifier>CODEN: BJSUAM</identifier><language>eng</language><publisher>Chichester, UK: John Wiley & Sons, Ltd</publisher><subject>Acetylglucosaminidase - urine ; Aged ; Albuminuria - etiology ; Alpha-Globulins - urine ; Anti-Inflammatory Agents - therapeutic use ; Aortic Aneurysm, Abdominal - surgery ; Biological and medical sciences ; Constriction ; Cytokines - metabolism ; Double-Blind Method ; General aspects ; Humans ; Kidney Diseases - prevention & control ; Kidney Diseases - urine ; Medical sciences ; Methylprednisolone - therapeutic use ; Middle Aged ; Postoperative Complications - prevention & control ; Preoperative Care - methods ; Reoperation ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; T-Lymphocytes, Helper-Inducer - drug effects ; T-Lymphocytes, Helper-Inducer - metabolism ; Vascular surgery: aorta, extremities, vena cava. Surgery of the lymphatic vessels</subject><ispartof>British journal of surgery, 2008-01, Vol.95 (1), p.50-56</ispartof><rights>Copyright © 2007 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.</rights><rights>2008 INIST-CNRS</rights><rights>Copyright (c) 2007 British Journal of Surgery Society Ltd.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3888-e1598e8284a5ba07365ddf0d066aba7dfdc42a3740765e891524153d25f9033c3</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fbjs.5978$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fbjs.5978$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>315,781,785,1418,4025,27928,27929,27930,45579,45580</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=19983641$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/18027383$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Turner, S.</creatorcontrib><creatorcontrib>Derham, C.</creatorcontrib><creatorcontrib>Orsi, N. M.</creatorcontrib><creatorcontrib>Bosomworth, M.</creatorcontrib><creatorcontrib>Bellamy, M. C.</creatorcontrib><creatorcontrib>Howell, S. J.</creatorcontrib><title>Randomized clinical trial of the effects of methylprednisolone on renal function after major vascular surgery</title><title>British journal of surgery</title><addtitle>Br J Surg</addtitle><description>Background:
Perioperative renal dysfunction following abdominal aortic aneurysm (AAA) repair is multifactorial and may involve hypotension, hypoxia and ischaemia–reperfusion injury. Studies of cardiac and hepatic transplant surgery have demonstrated beneficial effects on renal function of high‐dose methylprednisolone administered before surgery.
Methods:
Twenty patients undergoing elective open AAA repair were randomized to receive either methylprednisolone 10 mg/kg or dextrose (control) before induction of anaesthesia. Blood was analysed for a panel of cytokines representative of T helper cell type 1 and 2 subsets. Urine was analysed for subclinical markers of renal dysfunction (albumin, α1‐microglobulin and N‐acetyl‐β‐D‐glucosaminidase).
Results:
Data from 18 patients were analysed. Both groups demonstrated glomerular and proximal convoluted tubular dysfunction that was unaffected by steroid treatment. Steroid administration increased serum levels of urea and creatinine (both P < 0·001). The steroid group had increased interleukin 10 levels (P = 0·005 compared to controls). There were no differences between groups in overall surgical complications, length of intensive care unit (P = 0·821) and hospital (P = 0·719) stay, or 30‐day mortality.
Conclusion:
Methylprednisolone administration altered the cytokine profile favourably but adversely affected postoperative renal function. Copyright © 2007 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
Harmful to the kidneys</description><subject>Acetylglucosaminidase - urine</subject><subject>Aged</subject><subject>Albuminuria - etiology</subject><subject>Alpha-Globulins - urine</subject><subject>Anti-Inflammatory Agents - therapeutic use</subject><subject>Aortic Aneurysm, Abdominal - surgery</subject><subject>Biological and medical sciences</subject><subject>Constriction</subject><subject>Cytokines - metabolism</subject><subject>Double-Blind Method</subject><subject>General aspects</subject><subject>Humans</subject><subject>Kidney Diseases - prevention & control</subject><subject>Kidney Diseases - urine</subject><subject>Medical sciences</subject><subject>Methylprednisolone - therapeutic use</subject><subject>Middle Aged</subject><subject>Postoperative Complications - prevention & control</subject><subject>Preoperative Care - methods</subject><subject>Reoperation</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><subject>T-Lymphocytes, Helper-Inducer - drug effects</subject><subject>T-Lymphocytes, Helper-Inducer - metabolism</subject><subject>Vascular surgery: aorta, extremities, vena cava. Surgery of the lymphatic vessels</subject><issn>0007-1323</issn><issn>1365-2168</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2008</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpF0U1vEzEQBmALgWhakPgFyBe4bfHHeu09QgoFFIGgIBAXy7HH1MHrDfZuIfx6HDWQy4xGfjTS-EXoESXnlBD2bL0p56KX6g5aUN6JhtFO3UULQohsKGf8BJ2WsiGEciLYfXRCFWGSK75Aw0eT3DiEP-CwjSEFayKecqh19Hi6Bgzeg53Kfhxgut7FbQaXQhnjmACPCWdIVfs52SnU0fgJMh7MZsz4xhQ7R5NxmfN3yLsH6J43scDDQz9Dn1-9_LR83azeX75ZPl81liulGqCiV6CYao1YGyLrSc554kjXmbWRzjvbMsNlS2QnQPVUsJYK7pjwPeHc8jP09HbvNo8_ZyiTHkKxEKNJMM5FS0KVaNu-wscHOK8HcHqbw2DyTv_7oAqeHEA9xUSfTbKhHF3fK961tLrm1v0KEXbHd6L3AekakN4HpF-8vdr3ow9lgt__vck_dCe5FPrLu0stv3Yfllerb_qC_wWkVZJa</recordid><startdate>200801</startdate><enddate>200801</enddate><creator>Turner, S.</creator><creator>Derham, C.</creator><creator>Orsi, N. M.</creator><creator>Bosomworth, M.</creator><creator>Bellamy, M. C.</creator><creator>Howell, S. J.</creator><general>John Wiley & Sons, Ltd</general><general>Wiley</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>7X8</scope></search><sort><creationdate>200801</creationdate><title>Randomized clinical trial of the effects of methylprednisolone on renal function after major vascular surgery</title><author>Turner, S. ; Derham, C. ; Orsi, N. M. ; Bosomworth, M. ; Bellamy, M. C. ; Howell, S. J.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3888-e1598e8284a5ba07365ddf0d066aba7dfdc42a3740765e891524153d25f9033c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2008</creationdate><topic>Acetylglucosaminidase - urine</topic><topic>Aged</topic><topic>Albuminuria - etiology</topic><topic>Alpha-Globulins - urine</topic><topic>Anti-Inflammatory Agents - therapeutic use</topic><topic>Aortic Aneurysm, Abdominal - surgery</topic><topic>Biological and medical sciences</topic><topic>Constriction</topic><topic>Cytokines - metabolism</topic><topic>Double-Blind Method</topic><topic>General aspects</topic><topic>Humans</topic><topic>Kidney Diseases - prevention & control</topic><topic>Kidney Diseases - urine</topic><topic>Medical sciences</topic><topic>Methylprednisolone - therapeutic use</topic><topic>Middle Aged</topic><topic>Postoperative Complications - prevention & control</topic><topic>Preoperative Care - methods</topic><topic>Reoperation</topic><topic>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</topic><topic>T-Lymphocytes, Helper-Inducer - drug effects</topic><topic>T-Lymphocytes, Helper-Inducer - metabolism</topic><topic>Vascular surgery: aorta, extremities, vena cava. Surgery of the lymphatic vessels</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Turner, S.</creatorcontrib><creatorcontrib>Derham, C.</creatorcontrib><creatorcontrib>Orsi, N. M.</creatorcontrib><creatorcontrib>Bosomworth, M.</creatorcontrib><creatorcontrib>Bellamy, M. C.</creatorcontrib><creatorcontrib>Howell, S. J.</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>MEDLINE - Academic</collection><jtitle>British journal of surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Turner, S.</au><au>Derham, C.</au><au>Orsi, N. M.</au><au>Bosomworth, M.</au><au>Bellamy, M. C.</au><au>Howell, S. J.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Randomized clinical trial of the effects of methylprednisolone on renal function after major vascular surgery</atitle><jtitle>British journal of surgery</jtitle><addtitle>Br J Surg</addtitle><date>2008-01</date><risdate>2008</risdate><volume>95</volume><issue>1</issue><spage>50</spage><epage>56</epage><pages>50-56</pages><issn>0007-1323</issn><eissn>1365-2168</eissn><coden>BJSUAM</coden><abstract>Background:
Perioperative renal dysfunction following abdominal aortic aneurysm (AAA) repair is multifactorial and may involve hypotension, hypoxia and ischaemia–reperfusion injury. Studies of cardiac and hepatic transplant surgery have demonstrated beneficial effects on renal function of high‐dose methylprednisolone administered before surgery.
Methods:
Twenty patients undergoing elective open AAA repair were randomized to receive either methylprednisolone 10 mg/kg or dextrose (control) before induction of anaesthesia. Blood was analysed for a panel of cytokines representative of T helper cell type 1 and 2 subsets. Urine was analysed for subclinical markers of renal dysfunction (albumin, α1‐microglobulin and N‐acetyl‐β‐D‐glucosaminidase).
Results:
Data from 18 patients were analysed. Both groups demonstrated glomerular and proximal convoluted tubular dysfunction that was unaffected by steroid treatment. Steroid administration increased serum levels of urea and creatinine (both P < 0·001). The steroid group had increased interleukin 10 levels (P = 0·005 compared to controls). There were no differences between groups in overall surgical complications, length of intensive care unit (P = 0·821) and hospital (P = 0·719) stay, or 30‐day mortality.
Conclusion:
Methylprednisolone administration altered the cytokine profile favourably but adversely affected postoperative renal function. Copyright © 2007 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
Harmful to the kidneys</abstract><cop>Chichester, UK</cop><pub>John Wiley & Sons, Ltd</pub><pmid>18027383</pmid><doi>10.1002/bjs.5978</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0007-1323 |
| ispartof | British journal of surgery, 2008-01, Vol.95 (1), p.50-56 |
| issn | 0007-1323 1365-2168 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_70185449 |
| source | MEDLINE; Access via Wiley Online Library; Oxford University Press Journals All Titles (1996-Current) |
| subjects | Acetylglucosaminidase - urine Aged Albuminuria - etiology Alpha-Globulins - urine Anti-Inflammatory Agents - therapeutic use Aortic Aneurysm, Abdominal - surgery Biological and medical sciences Constriction Cytokines - metabolism Double-Blind Method General aspects Humans Kidney Diseases - prevention & control Kidney Diseases - urine Medical sciences Methylprednisolone - therapeutic use Middle Aged Postoperative Complications - prevention & control Preoperative Care - methods Reoperation Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases T-Lymphocytes, Helper-Inducer - drug effects T-Lymphocytes, Helper-Inducer - metabolism Vascular surgery: aorta, extremities, vena cava. Surgery of the lymphatic vessels |
| title | Randomized clinical trial of the effects of methylprednisolone on renal function after major vascular surgery |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-11T11%3A56%3A34IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Randomized%20clinical%20trial%20of%20the%20effects%20of%20methylprednisolone%20on%20renal%20function%20after%20major%20vascular%20surgery&rft.jtitle=British%20journal%20of%20surgery&rft.au=Turner,%20S.&rft.date=2008-01&rft.volume=95&rft.issue=1&rft.spage=50&rft.epage=56&rft.pages=50-56&rft.issn=0007-1323&rft.eissn=1365-2168&rft.coden=BJSUAM&rft_id=info:doi/10.1002/bjs.5978&rft_dat=%3Cproquest_pubme%3E70185449%3C/proquest_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=70185449&rft_id=info:pmid/18027383&rfr_iscdi=true |