ORIGINAL ARTICLE
Year : 2013  |  Volume : 7  |  Issue : 1  |  Page : 7-12

Does dexmedetomidine affect renal outcome in patients with renal impairment undergoing CABG?


1 Department of Anesthesia and Intensive Care, Cairo University, Cairo, Egypt
2 Department of Cardiothoracic Surgery, Faculty of Medicine, Cairo University, Cairo, Egypt

Correspondence Address:
Maged Salah
MD, Department of Anesthesia and Intensive Care, Faculty of Medicine, Cairo University, 11431 Cairo
Egypt
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Source of Support: None, Conflict of Interest: None


DOI: 10.7123/01.EJCA.0000430213.94124.cc

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Background

Dexmedetomidine, a centrally acting α2-adrenoceptor agonist, has been used as an adjunct to anesthesia and in sedation because of its efficient sympatholytic, analgesic, and anxiolytic properties. Recently, several studies have focused on the potential neuroprotective and renoprotective effects of dexmedetomidine in patients undergoing different surgical procedures.

Coronary artery bypass grafting (CABG) with cardiopulmonary bypass is associated with a high incidence of perioperative renal dysfunction that is believed to be caused partly by the increased sympathetic nervous system activity leading to compromised hemodynamics and attenuated renal function.

Aim of the work

To test the hypothesis that dexmedetomidine would exert a renal protective effect and prevent the development of acute kidney injury in patients with mild to moderate renal dysfunction undergoing elective CABG during the early postoperative days.

Methods

A double-blind randomized placebo-controlled study was carried out. Eighty adult patients with mild to moderate renal impairment (serum creatinine between 1.5–2 mg/dl) and scheduled for elective CABG with cardiopulmonary bypass were randomly allocated to either dexmedetomidine infusion or placebo infusion groups. Infusion was started after induction of anesthesia and continued until the end of surgery. The primary outcome variables measured for assessment of renal functions included serum creatinine, creatinine clearance, and urinary output in the 72 h postoperatively.

Results

No significant difference was detected for any indicators of renal function between both groups, except for an increase in urinary output in the dexmedetomidine infusion group in the first 24 h after surgery (P=0.007).

Conclusion

The use of dexmedetomidine infusion did not alter renal function in terms of serum creatinine or creatinine clearance but was associated with an increase in urinary output in the first 24 h.



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