• Young Rim Song, Taewoo Lee, Sun Jin You, Ho Joon Chin, Dong-Wan Chae, Cheong Lim, Kay-Hyun Park, Sunghee Han, Jin-Hee Kim, and Ki Young Na.
• Department of Internal Medicine and Kidney Research Institute, Hallym University College of Medicine, Anyang, Korea.
• Am. J. Nephrol. 2009 Jan 1;30(3):253-60.

Background/AimsDepending on the specific definition, acute kidney injury (AKI) occurs in 7-40% of patients undergoing cardiac surgery. Even small changes in serum creatinine (SCr) levels are associated with increased mortality after cardiac surgery. However, there are no current methods for preventing AKI after cardiac surgery. Erythropoietin (EPO) has been shown to elicit tissue-protective effects in various experimental models. In this pilot trial, we evaluated the effectiveness of EPO in the prevention of AKI after coronary artery bypass grafting (CABG).Methods71 patients scheduled for elective CABG randomly received either 300 U/kg of EPO or saline intravenously before surgery. AKI was defined as a 50% increase in SCr levels over baseline within the first 5 postoperative days. Estimated glomerular filtration rate (eGFR) was calculated from the Cockcroft-Gault equation.ResultsOf 71 patients, 13 developed postoperative AKI: 3 of the 36 patients in the EPO group (8%) and 10 of the 35 patients in the placebo group (29%; p = 0.035). The increase in postoperative SCr concentration and the decline in postoperative eGFR were significantly lower in the EPO group than in the placebo group.ConclusionsIn our small, pilot trial, prophylactic administration of EPO prevents AKI and improves postoperative renal function. These data are preliminary and require confirmation in a larger clinical trial.Copyright 2009 S. Karger AG, Basel.

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