Journal of Southern Medical University ›› 2023, Vol. 43 ›› Issue (4): 654-659.doi: 10.12122/j.issn.1673-4254.2023.04.21

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Dexmedetomidine can not reduce the incidence of acute and chronic kidney disease after laparoscopic radical nephrectomy: a propensity score matching-based analysis

Su Yuwei, Sun Wen, WANG Di, Dong Yuyan, DING Ying, XU Longhe, LIU Yongzhe   

  1. Department of Anesthesiology, the Third Medical Center, Chinese People's Liberation Army General Hospital, Beijing 100059, China; College of Anesthesia, Shanxi Medical University, Taiyuan 030001, China; Graduate School of Jinzhou Medical University, Jinzhou 121001, China
  • Online:2023-04-20 Published:2023-05-16

Abstract: Objective To investigate the effect of dexmedetomidine (DEX) on renal function after laparoscopic radical nephrectomy. Methods We reviewed the clinical data of 282 patients with renal cell carcinoma (RCC), who underwent laparoscopic radical nephrectomy (LRN) in the Department of Urology, Third Medical Center of PLA General Hospital from November, 2020 and June, 2022. According to whether DEX was used during the operation, the patients were divided into DEX group and control group, and after propensity score matching, 99 patients were finally enrolled in each group. The incidence of acute kidney injuries were compared between the two groups. Serum creatinine (sCr) data within 3 months to 1 year after the operation were available in 51 patients, including 26 in DEX group and 25 in the control group, and the incidence of chronic kidney disease (CKD) was compared between the two groups. Results After propensity score matching and adjustment for significant covariates, there were no significant differences in postoperative levels of sCr, cystatin C (CysC), β2-microglobulin (β2-MG), hemoglobin (Hb), or C-reactive protein (CRP), extubation time, incidence of AKI, or length of hospital stay between the two groups (P>0.05). The intraoperative urine volume was significantly higher in DEX group than in the control group (P<0.05). A significant correlation between AKI and CKD was noted in the patients (P<0.05). The incidence of CKD did not differ significantly between the two groups (P>0.05). Conclusion DEX can not reduce the incidence of AKI or CKD after LRN.

Key words: dexmedetomidine; radical nephrectomy; acute kidney injury; propensity score matching