When it comes to our health, we tend to focus on the big players—our heart, our brain, our lungs.
But there’s another vital organ that often gets overlooked, despite its crucial role in keeping our bodies functioning: our kidneys.
These powerhouse organs filter waste from our blood, regulate our fluid balance, and even help control our blood pressure. So, when your kidneys are at risk, your whole body suffers.
Unfortunately, one of the times our kidneys are put in jeopardy is during cardiac surgery.
Acute kidney injury (AKI) is a serious and frequent complication of these procedures, often caused by reduced blood flow to the kidneys during the operation.
But now, a groundbreaking new study has identified a simple, yet effective way to protect our kidneys during this vulnerable time.
The study, published in the New England Journal of Medicine, was a multinational, double-blind trial that randomly assigned adult patients undergoing cardiac surgery with cardiopulmonary bypass to receive either an intravenous infusion of a balanced mixture of amino acids or a placebo (Ringer’s solution) for up to 3 days.
The results were striking: AKI occurred in just 26.9% of patients in the amino acid group, compared to 31.7% in the placebo group.
That’s a 15% reduction in the risk of this potentially devastating complication. Even more impressively, the occurrence of stage 3 AKI—the most severe form—was nearly halved in the amino acid group (1.6% vs. 3.0%).
Let’s look at how amino acids, the building blocks of protein, protect our kidneys.
The answer lies in their ability to increase kidney perfusion—that is, the amount of blood flowing through these vital organs. By recruiting what’s known as the “renal functional reserve,” amino acids help ensure that our kidneys receive the oxygen and nutrients they need to function properly, even during the stress of surgery.
The implications of this study are profound. As the population ages and more people require cardiac surgery, the burden of AKI is only expected to grow. By providing a simple, safe, and effective way to reduce this risk, intravenous amino acids could help countless patients avoid the pain, expense, and long-term consequences of kidney damage.
Now, it’s important to remember that while these findings are exciting, they’re not the end of the story. As with any new medical treatment, there are still some unanswered questions that will need to be addressed.
For example, the researchers looked at several other outcomes besides just the occurrence of AKI, such as how many patients needed kidney-replacement therapy (like dialysis) and how long they needed it for, as well as the overall mortality rate at 30 days after surgery.
While the amino acid infusion seemed to help prevent AKI, it didn’t have a significant impact on these other measures.
Additionally, the study kept a close eye on any potential side effects or complications from the amino acid treatment, which is crucial for determining its safety. The good news is that there weren’t any major differences in adverse events between the patients who received amino acids and those who got the placebo.
However, it’s important to keep in mind that this study only followed patients for a relatively short period of time after their surgery. To get a full picture of how well this treatment works and how safe it is in the long run, researchers will need to keep tracking these patients over a longer timeframe.
So, while this study is definitely a promising step forward in protecting patients’ kidneys during cardiac surgery, it’s not the final word on the matter. As with all medical research, it’s an ongoing process of discovery, refinement, and validation.
Nevertheless, for anyone facing the prospect of cardiac surgery, the potential benefits of intravenous amino acids are well worth discussing with their healthcare team. And for all of us, this study serves as a powerful reminder of the importance of kidney health—and the exciting new frontiers in protecting these often-overlooked organs.
To a future of healthier hearts and happier kidneys,
Rachel Mace
Managing Editorial Director, e-Alert
with contributions from the research team
P.S. Are BP drugs destroying your kidneys? Get the full scoop here.
Sources:
Landoni, G., Monaco, F., Lian Kah Ti, Martina Baiardo Redaelli, Nikola Bradic, Comis, M., Kotani, Y., Brambillasca, C., Garofalo, E., Anna Mara Scandroglio, Viscido, C., Paternoster, G., Franco, A., Porta, S., Federica Ferrod, Maria Grazia Calabrò, Pisano, A., Igor Vendramin, Gaia Barucco, & Federici, F. (2024). A Randomized Trial of Intravenous Amino Acids for Kidney Protection. New England Journal of Medicine. https://doi.org/10.1056/nejmoa2403769
