Perioperative dexmedetomidine administration does not reduce the risk of acute kidney injury after non-cardiac surgery: a meta-analysis

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 dexmedeto...

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Main Authors: Bin Hu, Tian Tian, Xintao Li, Weichao Liu, Yinggui Chen, Tianyu Jiang, Peishan Chen, Fushan Xue, Jing Ni
Format: Article
Language:English
Published: Wolters Kluwer 2022-12-01
Series:Chinese Medical Journal
Online Access:http://journals.lww.com/10.1097/CM9.0000000000002408
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author Bin Hu
Tian Tian
Xintao Li
Weichao Liu
Yinggui Chen
Tianyu Jiang
Peishan Chen
Fushan Xue
Jing Ni
author_facet Bin Hu
Tian Tian
Xintao Li
Weichao Liu
Yinggui Chen
Tianyu Jiang
Peishan Chen
Fushan Xue
Jing Ni
author_sort Bin Hu
collection DOAJ
description 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.
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spelling doaj.art-690c54c1a0854a79922e6a1cb3e8761f2023-04-24T10:04:19ZengWolters KluwerChinese Medical Journal0366-69992542-56412022-12-01135232798280410.1097/CM9.0000000000002408202212050-00003Perioperative dexmedetomidine administration does not reduce the risk of acute kidney injury after non-cardiac surgery: a meta-analysisBin Hu0Tian Tian1Xintao Li2Weichao Liu3Yinggui Chen4Tianyu Jiang5Peishan Chen6Fushan Xue7Jing Ni8Department of Anesthesiology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China.Department of Anesthesiology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China.Department of Anesthesiology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China.Department of Anesthesiology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China.Department of Anesthesiology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China.Department of Anesthesiology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China.Department of Anesthesiology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China.Department of Anesthesiology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China.Department of Anesthesiology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China.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.http://journals.lww.com/10.1097/CM9.0000000000002408
spellingShingle Bin Hu
Tian Tian
Xintao Li
Weichao Liu
Yinggui Chen
Tianyu Jiang
Peishan Chen
Fushan Xue
Jing Ni
Perioperative dexmedetomidine administration does not reduce the risk of acute kidney injury after non-cardiac surgery: a meta-analysis
Chinese Medical Journal
title Perioperative dexmedetomidine administration does not reduce the risk of acute kidney injury after non-cardiac surgery: a meta-analysis
title_full Perioperative dexmedetomidine administration does not reduce the risk of acute kidney injury after non-cardiac surgery: a meta-analysis
title_fullStr Perioperative dexmedetomidine administration does not reduce the risk of acute kidney injury after non-cardiac surgery: a meta-analysis
title_full_unstemmed Perioperative dexmedetomidine administration does not reduce the risk of acute kidney injury after non-cardiac surgery: a meta-analysis
title_short Perioperative dexmedetomidine administration does not reduce the risk of acute kidney injury after non-cardiac surgery: a meta-analysis
title_sort perioperative dexmedetomidine administration does not reduce the risk of acute kidney injury after non cardiac surgery a meta analysis
url http://journals.lww.com/10.1097/CM9.0000000000002408
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