Intraoperative dexmedetomidine use is associated with lower incidence of acute kidney injury after non-cardiac surgery

Background Previous studies have shown that perioperative dexmedetomidine could reduce the incidence of postoperative AKI in cardiovascular surgery, however, its effectiveness in the non-cardiovascular surgery patient population has not been reported. The aim of this study was to investigate the eff...

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Main Authors: Yong-Zhong Tang, Qiong Wang, Li Zhi, Xing Liu, Yuan Le, Qin Liao, Bo Li, Wei Zhang
Format: Article
Language:English
Published: Taylor & Francis Group 2023-12-01
Series:Renal Failure
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Online Access:https://www.tandfonline.com/doi/10.1080/0886022X.2023.2192285
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author Yong-Zhong Tang
Qiong Wang
Li Zhi
Xing Liu
Yuan Le
Qin Liao
Bo Li
Wei Zhang
author_facet Yong-Zhong Tang
Qiong Wang
Li Zhi
Xing Liu
Yuan Le
Qin Liao
Bo Li
Wei Zhang
author_sort Yong-Zhong Tang
collection DOAJ
description Background Previous studies have shown that perioperative dexmedetomidine could reduce the incidence of postoperative AKI in cardiovascular surgery, however, its effectiveness in the non-cardiovascular surgery patient population has not been reported. The aim of this study was to investigate the effect of intraoperative dexmedetomidine on the incidence of postoperative AKI and postoperative ICU admissions in patients undergoing non-cardiovascular surgery.Design and setting A single-center retrospective cohort study obtained from the database of the Center for Anesthesia and Surgery, the Third Xiangya Hospital.Patients Inpatients between 18 and 75 years of age who were admitted to our hospital for non-cardiovascular surgery from 2012 to 2019.Results Overall 2391 patients who used dexmedetomidine intraoperatively were analyzed in comparison to 4552 patients who did not use dexmedetomidine after one-to-two matching. The two cohorts had similar baseline values and demographic characteristics. The incidence of AKI was lower in patients with intraoperative dexmedetomidine use than in the nonuse group (OR 0.60, p < .001). The rate of severe renal failure needing dialysis was also lower than in the nonuse group (β = –0.02, p < .05). After adjusting for confounding factors, the rate of AKI was still lower in the dexmedetomidine group. The rate of postoperative ICU admissions and in-hospital deaths were similar in the two groups (p > .05).Conclusion For non-cardiovascular surgery patient population, intraoperative use of dexmedetomidine was associated with a lower incidence and less severity of postoperative AKI. However, there was no significant correlation with postoperative ICU occupancy or in-hospital mortality. Further prospective RCTs are needed in the future.
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spelling doaj-art-4bac89ad3235452c9a6b9167fe514b722025-08-20T02:28:53ZengTaylor & Francis GroupRenal Failure0886-022X1525-60492023-12-0145110.1080/0886022X.2023.2192285Intraoperative dexmedetomidine use is associated with lower incidence of acute kidney injury after non-cardiac surgeryYong-Zhong Tang0Qiong Wang1Li Zhi2Xing Liu3Yuan Le4Qin Liao5Bo Li6Wei Zhang7Department of Anesthesiology of the Third Xiangya Hospital, Central South University, Changsha, ChinaDepartment of Cardiology of the Third Xiangya Hospital, Central South University, Changsha, ChinaDepartment of Nephrology of the Third Xiangya Hospital, Central South University, Changsha, ChinaDepartment of Anesthesiology of the Third Xiangya Hospital, Central South University, Changsha, ChinaDepartment of Anesthesiology of the Third Xiangya Hospital, Central South University, Changsha, ChinaDepartment of Anesthesiology of the Third Xiangya Hospital, Central South University, Changsha, ChinaOperation center of the Third Xiangya Hospital, Central South University, Changsha, ChinaDepartment of Nephrology of the Third Xiangya Hospital, Central South University, Changsha, ChinaBackground Previous studies have shown that perioperative dexmedetomidine could reduce the incidence of postoperative AKI in cardiovascular surgery, however, its effectiveness in the non-cardiovascular surgery patient population has not been reported. The aim of this study was to investigate the effect of intraoperative dexmedetomidine on the incidence of postoperative AKI and postoperative ICU admissions in patients undergoing non-cardiovascular surgery.Design and setting A single-center retrospective cohort study obtained from the database of the Center for Anesthesia and Surgery, the Third Xiangya Hospital.Patients Inpatients between 18 and 75 years of age who were admitted to our hospital for non-cardiovascular surgery from 2012 to 2019.Results Overall 2391 patients who used dexmedetomidine intraoperatively were analyzed in comparison to 4552 patients who did not use dexmedetomidine after one-to-two matching. The two cohorts had similar baseline values and demographic characteristics. The incidence of AKI was lower in patients with intraoperative dexmedetomidine use than in the nonuse group (OR 0.60, p < .001). The rate of severe renal failure needing dialysis was also lower than in the nonuse group (β = –0.02, p < .05). After adjusting for confounding factors, the rate of AKI was still lower in the dexmedetomidine group. The rate of postoperative ICU admissions and in-hospital deaths were similar in the two groups (p > .05).Conclusion For non-cardiovascular surgery patient population, intraoperative use of dexmedetomidine was associated with a lower incidence and less severity of postoperative AKI. However, there was no significant correlation with postoperative ICU occupancy or in-hospital mortality. Further prospective RCTs are needed in the future.https://www.tandfonline.com/doi/10.1080/0886022X.2023.2192285Dexmedetomidineacute kidney injurynon-cardiovascular surgeryretrospective study
spellingShingle Yong-Zhong Tang
Qiong Wang
Li Zhi
Xing Liu
Yuan Le
Qin Liao
Bo Li
Wei Zhang
Intraoperative dexmedetomidine use is associated with lower incidence of acute kidney injury after non-cardiac surgery
Renal Failure
Dexmedetomidine
acute kidney injury
non-cardiovascular surgery
retrospective study
title Intraoperative dexmedetomidine use is associated with lower incidence of acute kidney injury after non-cardiac surgery
title_full Intraoperative dexmedetomidine use is associated with lower incidence of acute kidney injury after non-cardiac surgery
title_fullStr Intraoperative dexmedetomidine use is associated with lower incidence of acute kidney injury after non-cardiac surgery
title_full_unstemmed Intraoperative dexmedetomidine use is associated with lower incidence of acute kidney injury after non-cardiac surgery
title_short Intraoperative dexmedetomidine use is associated with lower incidence of acute kidney injury after non-cardiac surgery
title_sort intraoperative dexmedetomidine use is associated with lower incidence of acute kidney injury after non cardiac surgery
topic Dexmedetomidine
acute kidney injury
non-cardiovascular surgery
retrospective study
url https://www.tandfonline.com/doi/10.1080/0886022X.2023.2192285
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