{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T01:39:13Z","timestamp":1769045953778,"version":"3.49.0"},"reference-count":31,"publisher":"Georg Thieme Verlag KG","issue":"07","license":[{"start":{"date-parts":[[2022,5,28]],"date-time":"2022-05-28T00:00:00Z","timestamp":1653696000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Thorac Cardiovasc Surg"],"published-print":{"date-parts":[[2022,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Objectives\u2003Acute kidney injury (AKI) is associated with higher perioperative mortality and morbidity. Oxidative stress has been proposed as a cause of postoperative AKI. Ascorbic acid (AA) supplementation was suggested as a novel and promising antioxidant. The aim of this study was to evaluate the capability of AA to reduce the incidence of postoperative AKI in cardiac surgery patients.<\/jats:p><jats:p>Methods\u2003A prospective randomized trial was conducted in patients scheduled for on-pump cardiac surgery. Subjects in the AA group received 2\u2009g of AA intravenously during the induction of anesthesia, 2\u2009g before aortic cross-clamp removal and 1\u2009g every 8\u2009hours for five postoperative days (the JERICA protocol). Postoperatively, the patients were monitored for AKI and other complications. Malondialdehyde levels were monitored in a subpopulation of 100 patients to evaluate the effect of AA on oxidative stress level.<\/jats:p><jats:p>Results\u2003The AA and control group consisted of 163 and 169 patients, respectively. The groups were well matched for baseline demographics and had similar intraoperative characteristics. The incidence of AKI in the AA and control group was 20.9 and 28.4%, respectively (p\u2009=\u20090.127). The estimated glomerular filtration rate did not differ between the study groups in the entire postoperative period. There was a trend toward higher malondialdehyde values with statistical significance on postoperative day 1 and lower in-hospital mortality in the AA group (0.6 vs. 4.1%, p\u2009=\u20090.067).<\/jats:p><jats:p>Conclusion\u2003Our results do not support the effectiveness of AA supplementation in reducing the incidence of postoperative AKI in on-pump cardiac surgery patients.<\/jats:p><jats:p>Clinical Registration Number\u2003This study was registered with the ISRCTN Registry under the trial registration number ISRCTN98572043.<\/jats:p>","DOI":"10.1055\/s-0042-1744262","type":"journal-article","created":{"date-parts":[[2022,5,28]],"date-time":"2022-05-28T22:30:26Z","timestamp":1653777026000},"page":"566-574","source":"Crossref","is-referenced-by-count":5,"title":["Effect of Ascorbic Acid on Cardiac Surgery-Associated Acute Kidney Injury Incidence"],"prefix":"10.1055","volume":"70","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7551-9534","authenticated-orcid":false,"given":"Anze","family":"Djordjevic","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, University Medical Centre Maribor, Maribor, Slovenia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stamenko","family":"Susak","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Institute of Cardiovascular Diseases of Vojvodina, Sremska Kamenica, Vojvodina, Serbia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Petra","family":"Kotnik","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Maribor, Maribor, Slovenia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mario","family":"Gorenjak","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Maribor, Maribor, Slovenia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zeljko","family":"Knez","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Maribor, Maribor, Slovenia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Miha","family":"Antonic","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, University Medical Centre Maribor, Maribor, Slovenia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2022,5,28]]},"reference":[{"issue":"22","key":"ref1","doi-asserted-by":"crossref","first-page":"1448","DOI":"10.1056\/NEJM199605303342207","article-title":"Acute renal failure","volume":"334","author":"R Thadhani","year":"1996","journal-title":"N Engl J Med"},{"issue":"12","key":"ref2","doi-asserted-by":"crossref","first-page":"2049","DOI":"10.1093\/ndt\/gfw374","article-title":"Prognostic implications of adding urine output to serum creatinine measurements for staging of acute kidney injury after major surgery: a cohort study","volume":"31","author":"S Quan","year":"2016","journal-title":"Nephrol Dial Transplant"},{"issue":"11","key":"ref3","doi-asserted-by":"crossref","first-page":"e008834","DOI":"10.1161\/JAHA.118.008834","article-title":"Cardiac and vascular surgery-associated acute kidney injury: The 20th International Consensus Conference of the ADQI (Acute Disease Quality Initiative) Group","volume":"7","author":"M K Nadim","year":"2018","journal-title":"J Am Heart Assoc"},{"key":"ref4","first-page":"1","article-title":"KDIGO Clinical Practice Guideline for acute kidney injury 2012","volume":"2","author":"J A Kellum","year":"2012","journal-title":"Kidney Int Suppl"},{"issue":"03","key":"ref5","doi-asserted-by":"crossref","first-page":"500","DOI":"10.2215\/CJN.07830814","article-title":"AKI associated with cardiac surgery","volume":"10","author":"R H Thiele","year":"2015","journal-title":"Clin J Am Soc Nephrol"},{"issue":"04","key":"ref6","doi-asserted-by":"crossref","first-page":"687","DOI":"10.4103\/0971-9784.191578","article-title":"Cardiac surgery-associated acute kidney injury","volume":"19","author":"C Ortega-Loubon","year":"2016","journal-title":"Ann Card Anaesth"},{"issue":"06","key":"ref7","doi-asserted-by":"crossref","first-page":"987","DOI":"10.1097\/SLA.0000000000001582","article-title":"Acute and chronic kidney disease and cardiovascular mortality after major surgery","volume":"264","author":"T Ozrazgat-Baslanti","year":"2016","journal-title":"Ann Surg"},{"key":"ref8","doi-asserted-by":"crossref","first-page":"29","DOI":"10.18690\/actabiomed.184","article-title":"Preoperative renal dysfunction is a predictor of postoperative atrial fibrillation in coronary artery bypass patients","volume":"12","author":"M Antonic","year":"2019","journal-title":"Acta Medico-Biotechnica"},{"issue":"05","key":"ref9","doi-asserted-by":"crossref","first-page":"389","DOI":"10.1055\/s-0039-1678565","article-title":"Predicting cardiac surgery-associated acute kidney injury using a combination of clinical risk scores and urinary biomarkers","volume":"68","author":"P Grieshaber","year":"2020","journal-title":"Thorac Cardiovasc Surg"},{"issue":"05","key":"ref10","doi-asserted-by":"crossref","first-page":"E214","DOI":"10.1532\/hsf.1811","article-title":"Effect of ascorbic acid on postoperative acute kidney injury in coronary artery bypass graft patients: a pilot study","volume":"20","author":"M Antonic","year":"2017","journal-title":"Heart Surg Forum"},{"issue":"03","key":"ref11","doi-asserted-by":"crossref","first-page":"562","DOI":"10.1093\/ejcts\/ezaa395","article-title":"Reduction in acute kidney injury post cardiac surgery using balanced forced diuresis: a randomized, controlled trial","volume":"59","author":"H Luckraz","year":"2021","journal-title":"Eur J Cardiothorac Surg"},{"issue":"11","key":"ref12","doi-asserted-by":"crossref","first-page":"697","DOI":"10.1038\/nrneph.2017.119","article-title":"Cardiac surgery-associated acute kidney injury: risk factors, pathophysiology and treatment","volume":"13","author":"Y Wang","year":"2017","journal-title":"Nat Rev Nephrol"},{"issue":"01","key":"ref13","first-page":"120","article-title":"Acute kidney injury after open-heart surgery procedures","volume":"60","author":"A Djordjevi\u0107","year":"2021","journal-title":"Acta Clin Croat"},{"key":"ref14","doi-asserted-by":"crossref","first-page":"110877","DOI":"10.1016\/j.biopha.2020.110877","article-title":"Pharmacodynamics of malondialdehyde as indirect oxidative stress marker after arrested-heart cardiopulmonary bypass surgery","volume":"132","author":"A Djordjevi\u0107","year":"2020","journal-title":"Biomed Pharmacother"},{"issue":"01","key":"ref15","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1016\/j.jjcc.2016.01.010","article-title":"Perioperative ascorbic acid supplementation does not reduce the incidence of postoperative atrial fibrillation in on-pump coronary artery bypass graft patients","volume":"69","author":"M Antonic","year":"2017","journal-title":"J Cardiol"},{"issue":"06","key":"ref16","doi-asserted-by":"crossref","first-page":"461","DOI":"10.7326\/0003-4819-130-6-199903160-00002","article-title":"A more accurate method to estimate glomerular filtration rate from serum creatinine: a new prediction equation","volume":"130","author":"A S Levey","year":"1999","journal-title":"Ann Intern Med"},{"issue":"01","key":"ref17","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1051\/ject\/201547016","article-title":"Acute kidney injury subsequent to cardiac surgery","volume":"47","author":"R S Kramer","year":"2015","journal-title":"J Extra Corpor Technol"},{"issue":"01","key":"ref18","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1016\/j.jss.2006.04.031","article-title":"The effects of iloprost and vitamin C on kidney as a remote organ after ischemia\/reperfusion of lower extremities","volume":"140","author":"A V Ozcan","year":"2007","journal-title":"J Surg Res"},{"issue":"07","key":"ref19","doi-asserted-by":"crossref","first-page":"718","DOI":"10.3390\/nu9070718","article-title":"Protective role for antioxidants in acute kidney disease","volume":"9","author":"J M Dennis","year":"2017","journal-title":"Nutrients"},{"issue":"05","key":"ref20","doi-asserted-by":"crossref","first-page":"1501","DOI":"10.3390\/nu12051501","article-title":"Two faces of vitamin C-antioxidative and pro-oxidative agent","volume":"12","author":"J Ka\u017amierczak-Bara\u0144ska","year":"2020","journal-title":"Nutrients"},{"issue":"09","key":"ref21","doi-asserted-by":"crossref","first-page":"2157","DOI":"10.3390\/nu11092157","article-title":"Perioperative vitamin C and E levels in cardiac surgery patients and their clinical significance","volume":"11","author":"A Hill","year":"2019","journal-title":"Nutrients"},{"key":"ref22","first-page":"13","article-title":"The perioperative effect of ascorbic acid on inflammatory response in coronary artery bypass graft surgery; a randomized controlled trial coronary artery bypass graft surgery","volume":"6","author":"R Jouybar","year":"2012","journal-title":"Int Cardiovasc Res J"},{"issue":"02","key":"ref23","doi-asserted-by":"crossref","first-page":"129","DOI":"10.21470\/1678-9741-2017-0071","article-title":"Selenium, vitamin C and N-acetylcysteine do not reduce the risk of acute kidney injury after off-pump CABG: a randomized clinical trial","volume":"33","author":"S Amini","year":"2018","journal-title":"Rev Bras Cir Cardiovasc"},{"issue":"01","key":"ref24","doi-asserted-by":"crossref","first-page":"45","DOI":"10.4103\/0971-9784.197834","article-title":"Comparative effect of grape seed extract (Vitis vinifera) and ascorbic acid in oxidative stress induced by on-pump coronary artery bypass surgery","volume":"20","author":"N Safaei","year":"2017","journal-title":"Ann Card Anaesth"},{"issue":"05","key":"ref25","doi-asserted-by":"crossref","first-page":"276","DOI":"10.1055\/s-2007-1016504","article-title":"The protective effects of high-dose ascorbic acid on myocardium against reperfusion injury during and after cardiopulmonary bypass","volume":"42","author":"H Dingchao","year":"1994","journal-title":"Thorac Cardiovasc Surg"},{"issue":"01","key":"ref26","doi-asserted-by":"crossref","first-page":"59","DOI":"10.3109\/14017439009101825","article-title":"Bubble and membrane oxygenators\u2013comparison of postoperative organ dysfunction with special reference to inflammatory activity","volume":"24","author":"L Nilsson","year":"1990","journal-title":"Scand J Thorac Cardiovasc Surg"},{"issue":"02","key":"ref27","doi-asserted-by":"crossref","first-page":"252","DOI":"10.1016\/S0022-5223(19)36089-1","article-title":"Complement activation during cardiopulmonary bypass. Comparison of bubble and membrane oxygenators","volume":"91","author":"N C Cavarocchi","year":"1986","journal-title":"J Thorac Cardiovasc Surg"},{"issue":"06","key":"ref28","doi-asserted-by":"crossref","first-page":"888","DOI":"10.1016\/S0022-5223(19)38697-0","article-title":"Deleterious effects of cardiopulmonary bypass. A prospective study of bubble versus membrane oxygenation","volume":"89","author":"W van Oeveren","year":"1985","journal-title":"J Thorac Cardiovasc Surg"},{"issue":"08","key":"ref29","doi-asserted-by":"crossref","first-page":"621","DOI":"10.1080\/003655101753267982","article-title":"Biochemical and hemodynamic effects of ascorbic acid and alpha-tocopherol in coronary artery surgery","volume":"61","author":"G L Oktar","year":"2001","journal-title":"Scand J Clin Lab Invest"},{"issue":"05","key":"ref30","doi-asserted-by":"crossref","first-page":"481","DOI":"10.1111\/aor.12779","article-title":"Creatinine, neutrophil gelatinase-associated lipocalin, and cystatin C in determining acute kidney injury after heart operations using cardiopulmonary bypass","volume":"41","author":"J M Kali\u0161nik","year":"2017","journal-title":"Artif Organs"},{"issue":"02","key":"ref31","first-page":"133","article-title":"Serum Klotho as a marker for early diagnosis of acute kidney injury after cardiac surgery","volume":"39","author":"A Jerin","year":"2020","journal-title":"J Med Biochem"}],"container-title":["The Thoracic and Cardiovascular Surgeon"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/s-0042-1744262.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,11,22]],"date-time":"2023-11-22T10:27:52Z","timestamp":1700648872000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/s-0042-1744262"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,5,28]]},"references-count":31,"journal-issue":{"issue":"07","published-online":{"date-parts":[[2022,10,12]]},"published-print":{"date-parts":[[2022,10]]}},"URL":"https:\/\/doi.org\/10.1055\/s-0042-1744262","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0171-6425","1439-1902"],"issn-type":[{"value":"0171-6425","type":"print"},{"value":"1439-1902","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,5,28]]}}}