Incidence of acute kidney injury after noncardiac surgery in patients receiving intraoperative dexmedetomidine: a retrospective study
Manuel A. Paredes-Flores,
Javier D. Lasala,
Teresa Moon,
Shreyas Bhavsar,
Katherine Hagan,
Sarah Huepenbecker,
Nicolas P. Carram,
Maria F. Ramirez,
Kamal Maheswari,
Lei Feng,
Juan P. Cata
Affiliations
Manuel A. Paredes-Flores
Advocate Christ Medical Center Internal Medicine Residency, Oak Lawn, IL, USA
Javier D. Lasala
Department of Anesthesiology and Perioperative Medicine, University of Texas MD Anderson Cancer Center, Houston, TX, USA; Anesthesiology and Surgical Oncology Research Group, Houston, TX, USA
Teresa Moon
Department of Anesthesiology and Perioperative Medicine, University of Texas MD Anderson Cancer Center, Houston, TX, USA
Shreyas Bhavsar
Department of Anesthesiology and Perioperative Medicine, University of Texas MD Anderson Cancer Center, Houston, TX, USA
Katherine Hagan
Department of Anesthesiology and Perioperative Medicine, University of Texas MD Anderson Cancer Center, Houston, TX, USA
Sarah Huepenbecker
Department of Gynecology and Reproductive Medicine, University of Texas MD Anderson Cancer Center, Houston, TX, USA
Nicolas P. Carram
Anesthesiology and Surgical Oncology Research Group, Houston, TX, USA; Department of Anaesthesia, Hospital General de Agudos ‘Teodoro Alvarez’, Ciudad Autónoma de Buenos Aires, Buenos Aires, Argentina
Maria F. Ramirez
Department of Anesthesiology and Perioperative Medicine, University of Texas MD Anderson Cancer Center, Houston, TX, USA; Anesthesiology and Surgical Oncology Research Group, Houston, TX, USA
Kamal Maheswari
Department of General Anesthesia and Outcomes Research, Anesthesia Institute, Cleveland Clinic, Cleveland, OH, USA
Lei Feng
Department of Biostatistics, University of Texas MD Anderson Cancer Center, Houston, TX, USA
Juan P. Cata
Department of Anesthesiology and Perioperative Medicine, University of Texas MD Anderson Cancer Center, Houston, TX, USA; Anesthesiology and Surgical Oncology Research Group, Houston, TX, USA; Corresponding author. Department of Anesthesiology and Perioperative Medicine, University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Background: Postoperative acute kidney injury (AKI) is a common complication and is associated with increased hospital length of stay and 30 day all-cause mortality. Unfortunately, we have neither a defined strategy to prevent AKI nor an effective treatment. In vitro, animal, and human studies have suggested that dexmedetomidine may have a renoprotective effect. We conducted a retrospective cohort study to evaluate if intraoperative dexmedetomidine was associated with a reduced incidence of AKI. Methods: We collected data from 6625 patients who underwent major non-cardiothoracic cancer surgery. Before and after propensity score matching, we compared the incidence of postoperative AKI in patients who received intraoperative dexmedetomidine and those who did not. AKI was defined according to the Kidney Disease Improving Global Outcomes (creatinine alone values) criteria and calculated for postoperative Days 1, 2, and 3. Results: Twenty per cent (n=1301) of the patients received dexmedetomidine. The mean [standard deviation] administered dose was 78 [49.4] mcg. Patients treated with dexmedetomidine were matched to those who did not receive the drug. Patients receiving dexmedetomidine had a longer anaesthesia duration than the non-dexmedetomidine group. The incidence of AKI was not significantly different between the groups (dexmedetomidine 8% vs no dexmedetomidine 7%; P=0.333). The 30 day rates of infection, cardiovascular complications, or reoperation attributable to bleeding were higher in patients treated with dexmedetomidine. The 30 day mortality rate was not statistically different between the groups. Conclusions: The administration of dexmedetomidine during major non-cardiothoracic cancer surgery is not associated with a reduction in AKI within 72 h after surgery.
