Acute Renal Failure Clinical Trial
Official title:
Effect of a Preoperative Calorie Restriction on Renal Function After Cardiac Surgery
The aim of this study is to assess the effect of a diet prior to cardiac surgery on the common postoperative decline of renal function. Until now, there is no known drug or procedure to preserve the kidneys from this impairment. Patients with a known kidney disease are especially at risk. A potential beneficial effect of a diet prior to surgery has been shown in investigations in mammals, therefore this study will investigate if a preoperative diet in patients with known kidney disease and scheduled heart surgery can attenuate or prevent a postoperative loss of kidney function.
Patients with cardiothoracic surgery are at risk for postoperative acute renal failure which
is associated with significant morbidity and mortality. There is no drug or procedure known
to prevent this loss of renal function. Experimental data suggests, that a preoperative
caloric restriction might provide kidney protection in this context. This clinical trial
investigates if this phenomenon is also applicable in humans. Patients with a increased risk
for a postoperative renal failure due to known chronic kidney disease are randomized in 2
groups. Patients of the diet group receive a calorie restriction to 60% of the calculated
daily energy rate from day -7 until day -1 (included) pre-surgery (day 0 corresponds to day
of surgery). Patients of the control group receive alimentation ad libitum.
Primary objective is the increase of serum creatinine in mg/dl 24 h after induction of
ischemia ("cross clamping") in comparison to baseline value obtained in the morning of the
day of surgery (day 0) in order to analyse if a preoperative calorie restriction as a
preventive strategy leads to a attenuation of postoperative kidney injury. Hypothesis: A
seven day calorie restriction reduces the increase of serum creatinine after cardiac surgery
in patients with known chronic kidney disease.
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