Background: Acute kidney injury (AKI) after cardiac surgery is a relatively common complication affecting short- and long-term survival. The renoprotective effect of vitamin D (VitD) has been confirmed in several experimental models. This study was conducted to evaluate the effect of high-dose VitD administration in patients with VitD insufficiency on the incidence of postoperative AKI, the urinary level of tubular biomarkers, and serum anti-inflammatory biomarker after coronary artery bypass graft. Design and Method: In this randomized double-blind controlled clinical trial, the patients were randomly allocated to either the VitD group (n = 50), receiving 150,000 IU VitD tablets daily for 3 consecutive days before surgery or the control group (n = 61), receiving placebo tablets. Results: There was no difference in the incidence of postoperative AKI between the groups. Both of the urinary levels of interleukin-18 and kidney injury molecule-1 were significantly increased after the operation (p #x3c; 0.001, for both). Also, the serum level of interleukin-10 was increased after 3 days of VitD supplementation (p = 0.001). In comparison with the control group, it remained on a higher level after the operation (p #x3c; 0.001) and the next day (p = 0.03). The patients with AKI had more postoperative bleeding and received more blood transfusion. Conclusion: VitD pretreatment was unable to impose any changes in the incidence of AKI and the urinary level of renal biomarkers. However, high-dose administration of VitD may improve the anti-inflammatory state before and after the operation. Further studies are needed to assess the renoprotective effect of VitD on coronary surgery patients.
Cardiorenal Med

中文翻译：

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一项随机、双盲、安慰剂对照、大剂量、短期维生素 D 给药预防心脏手术后急性肾损伤的临床试验

背景：心脏手术后的急性肾损伤 (AKI) 是影响短期和长期生存的相对常见的并发症。维生素 D (VitD) 的肾脏保护作用已在多个实验模型中得到证实。本研究旨在评估大剂量 VitD 给药对 VitD 不足患者术后 AKI 发生率、尿管生物标志物水平和冠状动脉旁路移植术后血清抗炎生物标志物的影响。设计与方法：在这项随机双盲对照临床试验中，患者被随机分配到 VitD 组（ n = 50），在术前连续 3 天每天服用 150,000 IU VitD 片或对照组（ n= 61)，接受安慰剂药片。结果：两组术后AKI发生率无差异。手术后尿白细胞介素18和肾损伤分子1的水平均显着升高（p #x3c；0.001，两者）。此外，在补充 VitD 3 天后，白细胞介素 10 的血清水平增加（p = 0.001）。与对照组相比，手术后（p #x3c；0.001）和第二天（p =0.03）保持在较高水平。AKI患者术后出血较多，输血较多。结论：VitD 预处理无法对 AKI 的发生率和肾脏生物标志物的尿液水平施加任何变化。但是，大剂量服用 VitD 可能会改善手术前后的抗炎状态。需要进一步的研究来评估 VitD 对冠状动脉手术患者的肾脏保护作用。
心肾医学