Early Postoperative L-arginine and Acute Kidney Injury After Cardiac Surgery

Acute kidney injury (AKI) is common after cardiac surgery, yet effective protective strategies remain limited. L-arginine is the substrate for endogenous nitric oxide (NO) synthesis and may improve renal perfusion and endothelial function. investigators emulated a target trial to evaluate whether early perioperative L-arginine was associated with a lower risk of AKI after cardiac surgery.

Inclusion Criteria: ·adults admitted to the ICU after CPB-assisted cardiac surgery Exclusion Criteria: * congenital heart disease, * surgery requiring deep hypothermic circulatory arrest, * a preoperative baseline estimated glomerular filtration rate (eGFR) below 30 mL/min/1.73 m², * AKI already present prior to ICU admission