Novos agentes terapêuticos
Foi feita uma revisão sobre o uso de outros agentes terapêuticos lançados recentemente, incluindo o peptídeo natriurético atrial, a teofilina, fator de crescimento semelhante à insulina, fator de crescimento epidérmico, depuradores de radicais livres de oxigênio, anticorpos contra moléculas de adesão e prostaglandinas.[17]Lameire N, Van Biesen W, Vanholder R. Acute renal failure. Lancet. 2005 Jan 29-Feb 4;365(9457):417-30.
http://www.ncbi.nlm.nih.gov/pubmed/15680458?tool=bestpractice.com
Nenhum demonstrou benefício claro na LRA humana.[17]Lameire N, Van Biesen W, Vanholder R. Acute renal failure. Lancet. 2005 Jan 29-Feb 4;365(9457):417-30.
http://www.ncbi.nlm.nih.gov/pubmed/15680458?tool=bestpractice.com
[138]Yamada H, Doi K, Tsukamoto T, et al. Low-dose atrial natriuretic peptide for prevention or treatment of acute kidney injury: a systematic review and meta-analysis. Crit Care. 2019 Feb 11;23(1):41.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6371622
http://www.ncbi.nlm.nih.gov/pubmed/30744687?tool=bestpractice.com
O efeito protetor das estatinas (administradas antes da intervenção ou cronicamente) permanece em debate.[71]Cho A, Lee YK, Sohn SY. Beneficial effect of statin on preventing contrast-induced acute kidney injury in patients with renal insufficiency: a meta-analysis. Medicine (Baltimore). 2020 Mar;99(10):e19473.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7478506
http://www.ncbi.nlm.nih.gov/pubmed/32150109?tool=bestpractice.com
[139]Pappy R, Stavrakis S, Hennebry TA, et al. Effect of statin therapy on contrast-induced nephropathy after coronary angiography: a meta-analysis. Int J Cardiol. 2011 Sep 15;151(3):348-53.
http://www.ncbi.nlm.nih.gov/pubmed/21636154?tool=bestpractice.com
[140]Zhang T, Shen LH, Hu LH, et al. Statins for the prevention of contrast-induced nephropathy: a systematic review and meta-analysis. Am J Nephrol. 2011;33(4):344-51.
https://www.karger.com/Article/FullText/326269
http://www.ncbi.nlm.nih.gov/pubmed/21430372?tool=bestpractice.com
[141]Zhang BC, Li WM, Xu YW. High-dose statin pretreatment for the prevention of contrast-induced nephropathy: a meta-analysis. Can J Cardiol. 2011 Nov-Dec;27(6):851-8.
http://www.ncbi.nlm.nih.gov/pubmed/21944277?tool=bestpractice.com
[142]Gandhi S, Mosleh W, Abdel-Qadir H, et al. Statins and contrast-induced acute kidney injury with coronary angiography. Am J Med. 2014 Oct;127(10):987-1000.
http://www.ncbi.nlm.nih.gov/pubmed/24852935?tool=bestpractice.com
[ 
]
Do statins help prevent acute kidney injury after surgical procedures requiring cardiac bypass?/cca.html?targetUrl=https://cochranelibrary.com/cca/doi/10.1002/cca.824/fullMostre-me a resposta A hipotermia controlada e a infusão de fosfatase alcalina recombinante podem ser benéficas, mas requerem mais experiência.[143]Susantitaphong P, Alfayez M, Cohen-Bucay A, et al. Therapeutic hypothermia and prevention of acute kidney injury: a meta-analysis of randomized controlled trials. Resuscitation. 2012 Feb;83(2):159-67.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3273643
http://www.ncbi.nlm.nih.gov/pubmed/21983123?tool=bestpractice.com
[144]Pickkers P, Heemskerk S, Schouten J, et al. Alkaline phosphatase for treatment of sepsis-induced acute kidney injury: a prospective randomized double-blind placebo-controlled trial. Crit Care. 2012 Jan 23;16(1):R14.
https://ccforum.biomedcentral.com/articles/10.1186/cc11159
http://www.ncbi.nlm.nih.gov/pubmed/22269279?tool=bestpractice.com
A eritropoetina não parece exercer efeitos nefroprotetores, e o tratamento com hormônio tireoidiano tem sido associado a desfechos mais desfavoráveis do que outros tratamentos possíveis para pacientes com LRA estabelecida; seu papel na prevenção da LRA não foi adequadamente investigado.[145]Kim JE, Song SW, Kim JY, et al. Effect of a single bolus of erythropoietin on renoprotection in patients undergoing thoracic aortic surgery with moderate hypothermic circulatory arrest. Ann Thorac Surg. 2016 Feb;101(2):690-6.
http://www.ncbi.nlm.nih.gov/pubmed/26576750?tool=bestpractice.com
[146]Nigwekar SU, Strippoli GF, Navaneethan SD. Thyroid hormones for acute kidney injury. Cochrane Database Syst Rev. 2013 Jan 31;(1):CD006740.
https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD006740.pub2/full
http://www.ncbi.nlm.nih.gov/pubmed/23440810?tool=bestpractice.com
O pré-condicionamento isquêmico remoto pareceu ser promissor na prevenção da LRA, mas duas revisões sistemáticas (incluindo mais de 28 ensaios clínicos randomizados e controlados) põem em dúvida o valor desse tratamento.[147]Yang Y, Lang XB, Zhang P, et al. Remote ischemic preconditioning for prevention of acute kidney injury: a meta-analysis of randomized controlled trials. Am J Kidney Dis. 2014 Oct;64(4):574-83.
http://www.ncbi.nlm.nih.gov/pubmed/24954246?tool=bestpractice.com
[148]Menting TP, Wever KE, Ozdemir-van Brunschot DMD, et al. Ischaemic preconditioning for the reduction of renal ischaemia reperfusion injury. Cochrane Database Sys Rev. 2017 Mar 4;(3):CD010777.
https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD010777.pub2/full
http://www.ncbi.nlm.nih.gov/pubmed/28258686?tool=bestpractice.com
[117]Moore PK, Hsu RK, Liu KD. Management of acute kidney injury: core curriculum 2018. Am J Kidney Dis. 2018 Feb 22;72(1):136-48.
https://www.ajkd.org/article/S0272-6386(17)31141-1/fulltext
http://www.ncbi.nlm.nih.gov/pubmed/29478864?tool=bestpractice.com
[ ]
What are the benefits and harms of ischemic preconditioning for reducing renal ischemia reperfusion injury?/cca.html?targetUrl=https://www.cochranelibrary.com/cca/doi/10.1002/cca.1728/fullMostre-me a resposta
