Intraoperative High-Dose Dexamethasone and Severe AKI after Cardiac Surgery

  • Jacob K
  • Leaf D
  • Dieleman J
 et al. 
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Administration of prophylactic glucocorticoids has been suggested as a strategy to reduce postoperative AKI and other adverse events after cardiac surgery requiring cardiopulmonary bypass. In this post hoc analysis of a large placebo-controlled randomized trial of dexamethasone in 4465 adult patients undergoing cardiac surgery, we examined severe AKI, defined as use of RRT, as a primary outcome. Secondary outcomes were doubling of serum creatinine level or AKI-RRT, as well as AKI-RRT or in-hospital mortality (RRT/death). The primary outcome occurred in ten patients (0.4%) in the dexamethasone group and in 23 patients (1.0%) in the placebo group (relative risk, 0.44; 95% confidence interval, 0.19 to 0.96). In stratified analyses, the strongest signal for potential benefit of dexamethasone was in patients with an eGFR

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  • K. A. Jacob

  • D. E. Leaf

  • J. M. Dieleman

  • D. van Dijk

  • A. P. Nierich

  • P. M. Rosseel

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