The dose-related effects of Dexmedetomidine on renal functions and serum neutrophil gelatinase-associated lipocalin values after coronary artery bypass grafting: a randomized, triple-blind, placebo-controlled study

Abstract

In our study, we found that Dexmedetomidine infusion for sedation after CABG under cardiopulmonary bypass can be useful in the prevention of kidney injury. Conventional renal function tests, including blood urea nitrogen, serum creatinine, urine output and creatinine clearance rate measurements typically may not detect the development of acute kidney dysfunction in the first 48-h postoperative period. Differences were detected in renal function in the early postoperative period and the development of acute kidney injury, as determined by measurements of blood NGAL levels, was significant and dose-dependent.

Perioperative dexmedetomidine reduces the incidence and severity of acute kidney injury following valvular heart surgery

“…Prospective studies showed that dexmedetomidine affected urine output but not postoperative creatinine clearance 25 or exerted no effect on either parameter in patients undergoing coronary artery bypass graft surgery. 10 A retrospective study showed that its use was associated with a lower incidence of AKI after cardiac surgery. 9 By contrast, another retrospective study showed that dexmedetomidine was associated with an increased incidence of renal failure, although it reduced mortality and other complications.…”

“…6,8 However, only a limited number of prospective studies have been conducted in that regard in cardiac surgical patients. Of interest, dexmedetomidine was administered postoperatively and not preemptively in most previous clinical studies, 9,10 whereas the preventive use of dexmedetomidine before renal insult could exert a greater protective effect than when used afterwards. 6 The aim of this prospective, randomized, and placebocontrolled trial was to investigate the effect of 24-h dexmedetomidine infusion starting immediately after anesthetic induction on the development of AKI after valvular heart surgery.…”

The Effect of Dexmedetomidine on Outcomes of Cardiac Surgery in Elderly Patients

“…A study showed that Dex could provide neurocognitive protection in an animal model. 34 In a retrospective cohort study, use of Dex was associated with a decrease in postoperative AKI, 11 particularly in patients with normal preoperative kidney function or mild chronic kidney disease. 10 However, the authors' data failed to show the relationship between the use of Dex and the reduction of AKI in the aged population.…”

“…Multiple studies have demonstrated that Dex has a protective effect on the heart, brain, and kidneys. [8][9][10][11] It was associated with decreased mortality, time to extubation, and hospital length of stay (LOS) in cardiac surgical patients. [12][13][14][15] The authors previously have published a study describing the effects of Dex on outcomes of patients undergoing cardiac surgery.…”

Comorbidity in Coronary Heart Disease Patients Undergoing Bypass Grafting: An Experience of Two Surgery Centers

“…АГ по результатам анамнеза и обследова-ния была выявлена у большинства пациентов двух центров -2322 (81,2%) больных. В других отечест-венных и ряде зарубежных исследований частота АГ у пациентов с КШ также превышает 80% (Россия 80-83%, Турция 84%, в Швейцарии 67%), тогда как в исследовании, проведенном в Бразилии, этот пока-затель ниже -73,1% [36,37]. По данным националь-ной базы данных США среди 125619 больных с изо-лированным КШ АГ определялась в 64,0 (пациенты, застрахованные в системе Medicare) -68,2% (паци-енты, застрахованные в системе Medicaid) случаев [38].…”