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

Abstract

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.

Keywords:

• Dexmedetomidine
• acute kidney injury
• non-cardiovascular surgery
• retrospective study

Ethics statement

This study was approved by the ethics committee of the third Xiangya hospital of Central South University (2020S264). Because of the observational nature of the study, informed consent was waived.

Author contributions

Y-ZT helped in designing the study, analyzing and interpreting the data, Q W helped in data collection and checking and drafting and revising the manuscript. Z L and X L helped in collecting, analyzing and interpreting the data, and revising the manuscript. Y L and Q L helped in analyzing and interpreting the data. B L helped in supervising, funding acquisition and drafting and revising the manuscript. W Z helped in designing the study, analyzing and interpreting the data and drafting and revising the manuscript.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

The raw data of experiments used to support the findings of this study are available from the corresponding author upon request.

Additional information

Funding

This work was supported by grants from the National Natural Sciences Foundation of China [No.81900633], the Natural Sciences Foundation of Hunan Province [No. 2021JJ40954, No. 2020JJ5854].