Anker, Alexandra M. and Ruewe, Marc and Prantl, Lukas and Baringer, Magnus and Pawlik, Michael T. and Zeman, Florian and Goecze, Ivan and Klein, Silvan M. (2024) Biomarker-guided acute kidney injury risk assessment under liberal versus restrictive fluid therapy - the prospective-randomized MAYDAY-trial. SCIENTIFIC REPORTS, 14 (1): 17094. ISSN 2045-2322,
Full text not available from this repository. (Request a copy)Abstract
Acute kidney injury (AKI) prevalence in surgical patients is high, emphasizing the need for preventative measures. This study addresses the insufficient evidence on nephroprotective intraoperative fluid resuscitation and highlights the drawbacks of relying solely on serum creatinine/urine output to monitor kidney function. This study assessed the impact of intraoperative fluid management on AKI in female breast cancer patients undergoing autologous breast reconstruction, utilizing novel urinary biomarkers (TIMP-2 and IGFBP-7). In a monocentric prospective randomized controlled trial involving 40 patients, liberal (LFA) and restrictive (FRV) fluid management strategies were compared. TIMP-2 and IGFBP-7 biomarker levels were assessed using the NephroCheck (bioMerieux, France) test kit at preoperative, immediate postoperative, and 24-h postoperative stages. FRV showed significantly higher immediate postoperative biomarker levels, indicating renal tubular stress. FRV patients had 21% (4/19) experiencing AKI compared to 13% (2/15) in the LFA group according to KDIGO criteria (p = 0.385). Restrictive fluid resuscitation increases the risk of AKI in surgical patients significantly, emphasizing the necessity for individualized hemodynamic management. The findings underscore the importance of urinary biomarkers in early AKI detection.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | ASSOCIATION; MARKERS; Acute kidney injury; Intraoperative fluid management; Fluid therapy; Breast neoplasms/surgery; Breast reconstruction; Urinary biomarkers |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Anästhesiologie Medicine > Lehrstuhl für Chirurgie Medicine > Zentren des Universitätsklinikums Regensburg > Zentrum für Klinische Studien Medicine > Zentren des Universitätsklinikums Regensburg > Zentrum für Plastische-, Hand- und Wiederherstellungschirurgie |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 25 Jul 2025 11:28 |
| Last Modified: | 25 Jul 2025 11:28 |
| URI: | https://pred.uni-regensburg.de/id/eprint/63806 |
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