Introduction 1 2 3 4 5 6 7 8 9 S 10 Material and methods Patients Nine patients received a 4 h continuous infusion of 1 mg/kg per hour MB (1% w/v) provided by the VieCuri Medical Center pharmacy (for inclusion criteria see Electronic Supplementary Material, ESM). Arterial blood and catheterized urine were collected at several time points during the first 24 h. Clinical parameters, the severity of illness using Acute Physiology and Chronic Health Evaluation II (APACHE II), and Sepsis-Related Organ Failure Assessment (SOFA) were recorded. Chemical assays 11 13 3 Statistical analysis p Results Patients 9 p MB attenuates NO formation 3 1 p 1 p 1 Fig. 1 S GST a n b n c n d n p p  MB attenuates kidney damage 1 p 1 1 p 1 Table 1 n  Median Range Total urine volume, 0–24 h (ml) 495 169–885 Protein excretion, 0–24 h (mg/day) 342 245–434 Creatinine clearance (ml/min)    Baseline  8.2  4.2–17.4  24 h  10.6*  9.6–14.8 Blood urea nitrogen    Baseline  17.8  10.8–20.0  24 h  17.3  10.4–22.5 Fractional excretion of sodium (%)    > 2%   n – – n  3.1  2.6–3.6  < 1%   n  0.6  0.3–0.7 n  0.4  0.2–0.5 p Discussion 9 3 14 2 15 3 16 17 18 19 In conclusion, short-term infusion of MB in septic patients with refractory shock, is associated with a decrease in NO production and an attenuation of the urinary excretion of renal tubular injury markers. Electronic supplementary material Electronic Supplementary Material (DOC 26K) Electronic Supplementary Material (DOC 37K)