Efek Pemberian Asam Amino untuk Mencegah Acute Kidney Injury (AKI) Pasca-Operasi Jantung
Tinjauan Sistematik
DOI:
https://doi.org/10.55175/cdk.v52i11.1724Kata Kunci:
Acute kidney injury, asam amino, bedah jantungAbstrak
Pendahuluan: Pemberian asam amino dapat menjadi pendekatan yang aman dan efektif untuk mengurangi risiko acute kidney injury (AKI) setelah operasi jantung. Metode: Tinjauan sistematis ini menggunakan data dari berbagai sumber ilmiah, seperti PubMed, ProQuest, ScienceDirect, dan Google Scholar, yang diterbitkan antara 1 Januari hingga 1 November 2024. Analisis atas 3 studi uji
acak terkontrol dengan total 3.647 pasien. Hasil: Insiden AKI tercatat pada 26,6% pasien di kelompok asam amino dibandingkan dengan 31,9% di kelompok kontrol (RR = 0,67; 95% CI [0,43–1,06]; I² = 52,5%; p = 0,0854). Selain itu, risiko AKI stadium 1 (21,1% vs 24,5%; RR 0,86; 95% CI [0,77–0,96]; I² = 0%) dan stadium 3 (0,15% vs 0,3%; RR 0,52; 95% CI [0,34–0,81]; I² = 0%) juga lebih rendah
pada kelompok asam amino. Tidak ada efek samping serius yang dilaporkan dalam penelitian-penelitian tersebut. Studi ini dilakukan dengan analisis risiko bias menggunakan alat Cochrane Risk of Bias-2 (RoB2), dan pengolahan data menggunakan perangkat lunak R. Simpulan: Hasil ini menunjukkan bahwa asam amino dapat memberikan manfaat klinis dalam pencegahan AKI, khususnya pada stadium 1 dan 3, tanpa meningkatkan risiko efek samping serius.
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Referensi
Yang X, Zhu L, Pan H, Yang Y. Cardiopulmonary bypass associated acute kidney injury: better understanding and better prevention.Ren Fail. 2024;46(1):2331062. doi: 10.1080/0886022X.2024.2331062.
Scurt FG, Bose K, Mertens PR, Chatzikyrkou C, Herzog C. Cardiac surgery-associated acute kidney injury kidney. 2024 ;5(6):909–6. doi: 10.34067/KID.0000000000000466.
Faguer S, Selby NM, Seigneux SDE, Cantaluppi V, Gameiro J, Lopes JA, et al. Does amino acid infusion improve kidney outcomes in patients at high risk for postsurgical AKI? Nephrol Dial Transplant. 2025;40(3):412–4. doi: 10.1093/ndt/gfae183.
Kellum JA, Romagnani P, Ashuntantang G, Ronco C, Zarbock A, Anders HJ. Acute kidney injury. Nat Rev Dis Primers. 2021;7(1):52. doi: 10.1038/s41572-021-00284-z.
Cheruku SR, Raphael J, Neyra JA, Fox AA. Acute kidney injury after cardiac surgery: prediction, prevention, and management. Anesthesiology 2023;139(6):880–98. doi: 10.1097/ALN.0000000000004734.
Chew STH, Hwang NC. Acute kidney injury after cardiac surgery: a narrative review of the literature. J Cardiothorac Vasc Anesth. 2019;33(4):1122–38. doi: 10.1053/j.jvca.2018.08.003.
Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021;372:n71. doi: 10.1136/bmj.n71.
Page MJ, Moher D, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. PRISMA 2020 explanation and elaboration: updated guidance and exemplars for reporting systematic reviews. BMJ. 2021;372:n160. doi: 10.1136/bmj.n160.
Pruna A, Losiggio R, Landoni G, Kotani Y, Redaelli MB, Veneziano M, et al. Amino acid infusion for perioperative functional renal protection: a meta-analysis. J Cardiothorac Vasc Anesth. 2024;38(12):3076–85. doi: 10.1053/j.jvca.2024.08.033.
Willim HA, Sugandi E, Rosa, Sani AA, Khouw H. Efficacy of cilostazol in promoting the maturation of newly created arteriovenous fistula in patients with end-stage renal disease: a systematic review and meta-analysis. Med J Indones. 2024;33(1):35–41. https://doi.org/10.13181/mji.oa.247252.
Higgins JPT, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, et al. Cochrane handbook for systematic reviews of interventions v.6.5. Cochrane [Internet]. 2024. Available from: www.training.cochrane.org/handbook.
R Core Team. The R project for statistical computing. R Foundation for Statistical Computing [Internet]. 2021. Available from: https://www.R-project.org/.13. Gandhi AP, Shamim MA, Padhi BK. Steps in undertaking meta-analysis and addressing heterogeneity in meta-analysis. The Evidence 2023;1(1):78–92. https://doi.org/10.61505/evidence.2023.1.1.7.
Kazawa M, Kabata D, Yoshida H, Minami K, Maeda T, Yoshitani K, et al. Amino acids to prevent cardiac surgery-associated acute
kidney injury: a randomized controlled trial. JA Clin Rep. 2024;10(1):19. doi: 10.1186/s40981-024-00703-6.
Landoni G, Monaco F, Ti LK, Redaelli MB, Bradic N, Comis M, et al. A randomized trial of intravenous amino acids for kidney protection.
N Engl J Med. 2024;391(8):687–98. doi: 10.1056/NEJMoa2403769.
Pu H, Doig GS, Heighes PT, Allingstrup MJ, Wang A, Brereton J, et al. Intravenous amino acid therapy for kidney protection in cardiac
surgery patients: a pilot randomized controlled trial. J Thorac Cardiovasc Surg. 2019;157(6):2356–66. doi: 10.1016/j.jtcvs.2018.11.097.
Chawla LS, Ronco C. Renal stress testing in the assessment of kidney disease. Kidney Int Rep. 2016;1(1):57–63. doi: 10.1016/j.
ekir.2016.04.005.
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Hak Cipta (c) 2025 Lukman Nur Rahman, Munzir Makarim, Muh. Azrief Khaidir Anjar, Muh. Syawaludin Sakti Maulana, Rais Trisiyambudin, Greyson Efraldi Sampe, Rifal Faali, Muhammad Hilmi Falah, Muh. Ikmaluddin Furqon, Dzar Ghifari Muh Rizal
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