Terashi T, Takehara A, Kuniyoshi T, Matsunaga A, Kawasaki K, Kanmura Y. Remifentanil temporarily improves renal function in adult patients with chronic kidney disease undergoing orthopedic surgery.
J Anesth 2013;
27:340-5. [PMID:
23412013 DOI:
10.1007/s00540-012-1545-9]
[Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2012] [Accepted: 12/12/2012] [Indexed: 12/20/2022]
Abstract
PURPOSE
The objective of this study was to confirm the renal protective effect of remifentanil-based anesthesia in perioperative adult patients with chronic kidney disease (CKD).
METHODS
A total of 90 non-dialysis perioperative adult patients with CKD, with preoperative estimated glomerular filtration rate from creatinine (eGFRcreat) values of lower than 50 ml/min/1.73 m(2), who had undergone orthopedic surgery under general anesthesia were retrospectively selected. The subjects were divided into two groups according to whether or not remifentanil was used for anesthesia management: group R, in which remifentanil was used for anesthesia management (n = 45), and group NR, in which remifentanil was not used for anesthesia (n = 45). eGFRcreat was measured pre-surgery (pre), 7 days after surgery (day-7), and 14 days after surgery (day-14).
RESULTS
In group R, both day-7 eGFRcreat (52.2 ± 17.0 ml/min/1.73 m(2)) and day-14 eGFRcreat (49.7 ± 15.5 ml/min/1.73 m(2)) were significantly higher than the pre eGFRcreat (40.7 ± 7.5 ml/min/1.73 m(2)) (day-7: p < 0.01; day-14: p < 0.01). In group NR, on the other hand, pre eGFRcreat (37.8 ± 7.6 ml/min/1.73 m(2)), day-7 eGFRcreat (41.2 ± 10.9 ml/min/1.73 m(2)), and day-14 eGFRcreat (40.2 ± 10.5 ml/min/1.73 m(2)) values were similar. Furthermore, both day-7 eGFRcreat and day-14 eGFRcreat were significantly higher in group R than in group NR (day-7: p < 0.01; day-14: p < 0.01).
CONCLUSIONS
Our findings suggest that anesthesia management using remifentanil may have a renal protective effect in perioperative adult CKD patients undergoing orthopedic surgery.
Collapse