Perioperative dexmedetomidine administration does not reduce the risk of acute kidney injury after non-cardiac surgery: a meta-analysis
10.1097/CM9.0000000000002408
- VernacularTitle:Perioperative dexmedetomidine administration does not reduce the risk of acute kidney injury after non-cardiac surgery: a meta-analysis
- Author:
Bin HU
1
;
Tian TIAN
;
Xintao LI
;
Weichao LIU
;
Yinggui CHEN
;
Tianyu JIANG
;
Peishan CHEN
;
Fushan XUE
Author Information
1. Department of Anesthesiology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
- Keywords:
Dexmedetomidine;
Non-cardiac surgery;
Acute kidney injury;
Meta-analysis
- From:
Chinese Medical Journal
2022;135(23):2798-2804
- CountryChina
- Language:Chinese
-
Abstract:
Background::Post-operative acute kidney injury (AKI) is one of the most common and serious complications after major surgery and is significantly associated with increased risks of morbidity and mortality. This meta-analysis was conducted to evaluate the effects of perioperative dexmedetomidine (Dex) administration on the occurrence of AKI and the outcomes of recovery after non-cardiac surgery.Methods::The PubMed, Embase, Web of Science, and Cochrane Library databases were systematically searched for studies comparing the effects of Dex vs. placebo on kidney function after non-cardiac surgery, and a pooled fixed-effect meta-analysis of the included studies was performed. The primary outcome was the occurence of post-operative AKI. The secondary outcomes included the occurence of intra-operative hypotension and bradycardia, intensive care unit (ICU) admission, duration of ICU stay, and hospital length of stay (LOS). Results::Six studies, including four randomized controlled trials (RCTs) and two observational studies, with a total of 2586 patients were selected. Compared with placebo, Dex administration could not reduce the odds of post-operative AKI (odds ratio [OR], 0.44; 95% confidence interval (CI), 0.18-1.06; P= 0.07; I2= 0.00%, P= 0.72) in RCTs, but it showed a significant renoprotective effect (OR, 0.67; 95% CI, 0.48-0.95; P = 0.02; I2 = 0.00%, P = 0.36) in observational studies. Besides, Dex administration significantly increased the odds of intra-operative bradycardia and shortened the duration of ICU stay. However, there was no significant difference in the odds of intra-operative hypotension, ICU admission, and hospital LOS. Conclusions::This meta-analysis suggests that perioperative Dex administration does not reduce the risk of AKI after non-cardiac surgery. However, the quality of evidence for this result is low due to imprecision and inconsistent types of non-cardiac operations. Thus, large and high-quality RCTs are needed to verify the real effects of perioperative Dex administration on the occurrence of AKI and the outcomes of recovery after non-cardiac surgery.
