Animal studies of minocycline therapy to prevent acute kidney injury (AKI) have been promising, but does it have the same effects in humans after cardiac bypass surgery (CABG)? Published in the Journal of Nephrology, a double-blind, placebo-controlled, multicenter study of 40 high-risk patients scheduled to undergo CABG randomized individuals to receive at least four doses of minocycline prophylaxis twice daily prior to surgery or placebo. The primary outcome of AKI [0.3mg/dL increase in creatinine (Cr)] within five days post-surgery occurred in 52.6% of patients in the minocycline prophylaxis arm vs. 36.8% of those in the placebo group. No differences were seen in post-operative length of stay and cardiovascular events between the two groups, although death at 30 days occurred in 10.5% of the placebo group and none in the minocycline group. On the first day following surgery, a greater trend towards lower diastolic pulmonary artery pressure and central venous pressure was observed in the minocycline group vs. placebo. While minocycline prophylaxis may be beneficial for further study on recovery from CABG, this study does not support its use in preventing AKI after CABG.
Acute kidney injury (AKI) after cardiac bypass surgery (CABG) is common and carries a significant association with morbidity and mortality.