Article description

Summary:

• A meta-analysis aimed to evaluate the efficacy of intravenous AA (amino acid) infusion for perioperative renal function protection;
• Meta-analysis included 14 randomized controlled trials and 1 prospective before after study with a study population sample size of 4,364 patients; 3 low risk of bias studies, 2 with some concerns, and 10 judged at high risk of bias;
• The primary outcome analysis showed that acute kidney injury (AKI) occurred in 504 of 2,041 patients (24.7%) in the AA group compared to 614 of 2,041 patients (30.1%) in the control group (risk ratio [RR], 0.66; 95% confidence interval [CI], 0.47–0.94; I² = 50%; p = 0.02), corresponding to a 99.1% probability of AKI reduction with AA;
• Secondary outcomes showed significant improvements of renal functional markers in the AA group, including lower serum creatinine (6 studies; MD –0.07 mg/dL; 95% CI, –0.12 to –0.02; I² = 58%; p = 0.01) and higher eGFR (4 studies; MD 5.2 mL/min/m²; 95% CI, 2.44–7.95; I² = 80%; p < 0.001), along with a reduced hospital length of stay by approximately 1 day (MD –1.02 days; 95% CI, –1.75 to –0.29; I² = 93%; p = 0.006);
• No statistically significant differences were observed between the groups regarding the duration of mechanical ventilation, length of stay in the intensive care unit, or mortality rates.

Conclusions:

• Meta-analysis indicates that AA administration is associated with a reduced risk of perioperative acute kidney injury;
• Although level 1 evidence supports the benefits of AA infusion on perioperative renal function in cardiac surgery, more research is needed to assess its long-term effects.