• Ladan Golestaneh, Kathryn Lindsey, Pooja Malhotra, Faraj Kargoli, Emily Farkas, Hendrick Barner, Rizwan Qazi, Anna Schmidt, Michael Rauchman, Ziyad Al-Aly, Robert Johnson, Kevin Martin, Pierre Dagher, Allon Friedman, and Tarek M El-Achkar.
• Montefiore Medical Center, Albert Einstein Medical Center, 3411 Wayne Ave, Suite 5H, Bronx, NY, 10467, USA, lgolesta@montefiore.org.
• J. Nephrol. 2015 Apr 1; 28 (2): 193-9.

Background And ObjectivesAcute kidney injury (AKI) after cardiac bypass surgery (CABG) is common and carries a significant association with morbidity and mortality. Since minocycline therapy attenuates kidney injury in animal models of AKI, we tested its effects in patients undergoing CABG.Design, Setting, Participants And MeasurementsThis is a randomized, double-blinded, placebo-controlled, multi-center study. We screened high risk patients who were scheduled to undergo CABG in two medical centers between Jan 2008 and June 2011. 40 patients were randomized and 19 patients in each group completed the study. Minocycline prophylaxis was given twice daily, at least for four doses prior to CABG. Primary outcome was defined as AKI [0.3 mg/dl increase in creatinine (Cr)] within 5 days after surgery. Daily serum Cr for 5 days, various clinical and hemodynamic measures and length of stay were recorded.ResultsThe two groups had similar baseline and intra-operative characteristics. The primary outcome occurred in 52.6% of patients in the minocycline group as compared to 36.8% of patients in the placebo group (p = 0.51). Peak Cr was 1.6 ± 0.7 vs. 1.5 ± 0.7 mg/dl (p = 0.45) in minocycline and placebo groups, respectively. Death at 30 days occurred in 0 vs. 10.5% in the minocycline and placebo groups, respectively (p = 0.48). There were no differences in post-operative length of stay, and cardiovascular events between the two groups. There was a trend towards lower diastolic pulmonary artery pressure [16.8 ± 4.7 vs. 20.7 ± 6.6 mmHg (p = 0.059)] and central venous pressure [11.8 ± 4.3 vs. 14.6 ± 5.6 mmHg (p = 0.13)] in the minocycline group compared to placebo on the first day after surgery.ConclusionsMinocycline did not protect against AKI post-CABG.

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