Does zinc possess renoprotective properties in patients under cardiac surgery?
Seyed Mahmood Nouraei
Department of Thoracic and Cardiovascular Surgery, Faculty of Medicine, Mazandran University of Medical Sciences, Sari, Iran
|Date of Web Publication||31-Oct-2017|
Seyed Mahmood Nouraei
Department of Thoracic and Cardiovascular Surgery, Faculty of Medicine, Mazandran University of Medical Sciences, Sari
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Nouraei SM. Does zinc possess renoprotective properties in patients under cardiac surgery?. J Res Med Sci 2017;22:119
Acute kidney injury (AKI) is a serious and common postoperative complication of cardiac surgery (CS) with incidence and mortality rate. The most prominent pathologic mechanism of AKI following CS is acute tubular necrosis. The inflammatory responses, the production of free radicals, and tubular oxidative stress, which are triggered by CS, play an important role in the tubular necrosis. Hence, it seems that the modification of inflammatory responses and reduction of renal tubular oxidative stress become main therapeutic targets. No proven intervention has demonstrated a definitive renal protection during CS, so far. Some pharmacological agents have revealed protective benefits on renal function; however, the current evidence is controversial. Therefore, finding effective and promising interventions for preventing this complication remains a priority for future research.
Following stress and trauma such as CS, the induction of acute phase response, and production of proinflammatory cytokines redistribute micronutrients from the vascular compartment; consequently, the plasma concentration of micronutrients is declined. In these cases, evidence suggesting supplementation with antioxidant and anti-inflammatory micronutrients such as zinc can form antioxidant defense mechanisms, downregulate cytokine production, and decline cytokine concentrations and hence can reduce oxidant injury to cells and organs., Since several renal diseases are mediated by oxidant injury, decreasing the production of reactive oxygen molecules or treating with antioxidant agents may open new avenues for research into therapeutic intervention.
Zinc is capable of decreasing postischemic injury to different organs such as kidney. It can antagonize the transition of metal-catalyzed reactions and reduce the formation of hydroxyl radical from hydrogen peroxide. However, its effectiveness has not been tested in a trial regarding CS-associated AKI. Berger et al. found that antioxidant supplementation could significantly reduce the inflammatory responses in patients under CS.
Finally, zinc possesses an antioxidant and anti-inflammatory properties; it is safe, nontoxic, inexpensive, and widely available antioxidant. Therefore, its effectiveness and efficacy should be evaluated in future trials to find answer to this question: Does zinc possess renoprotective properties in patients under cardiac surgery?
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Conflicts of interest
There are no conflicts of interest.
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