Korean J Anesthesiol.  2004 Nov;47(5):759-763. 10.4097/kjae.2004.47.5.759.

Acute Renal Failure after Operation Associated with Aprotinin: Report of 3 cases

• Kim SC
• Eom HS
• Ok SY
• Kim SI

• KMID: 2236685
• DOI: http://doi.org/10.4097/kjae.2004.47.5.759

Abstract

Aprotinin is a serine protease inhibitor and a powerful antifibrinolytic agent, derived from the inhibition of plasmin and kallikrein. Therefore, it is widely used in cardiopulmonary bypass surgery or major surgery for reducing bleeding and blood transfusion requirements. Aprotinin is rapidly eliminated from the circulation by glomerular filtration and is actively reabsorbed in the renal tubular system, where it is stored, metabolized, and eliminated over the following 5-6 days. Because of this metabolism, concerns have been raised regarding the possibility that aprotinin may impair renal function due to a toxic effects on proximal tubular cells. We report three cases of postoperative renal failure after aprotinin had been used during surgery. Two patients, Jehovah's Witnesses who refused blood transfusion, required hemodialysis. One patient, who underwent spinal orthopedic surgery, was administered aprotinin to reduce intraoperative blood loss, and developed acute renal dysfunction. The patient recovered after supportive therapy.

Keyword

aprotinin; complication; acute renal failure

MeSH Terms

Acute Kidney Injury*
Aprotinin*
Blood Transfusion
Cardiopulmonary Bypass
Fibrinolysin
Filtration
Hemorrhage
Humans
Jehovah's Witnesses
Kallikreins
Metabolism
Orthopedics
Renal Dialysis
Renal Insufficiency
Serine Proteases
Aprotinin
Fibrinolysin
Kallikreins
Serine Proteases