Acute kidney injury (AKI), a clinical syndrome, is a sudden onset of kidney failure that severely affects the kidney tubules. One potential treatment is dexmedetomidine (DEX), a highly selective α2-adrenoreceptor agonist that is used as an anesthetic adjuvant. It also has anti-inflammatory, neuroprotective, and sympatholytic qualities. The aim of this study was to establish whether DEX also offers protection against ischemia and reperfusion- (I/R-) induced AKI in rats. An intraperitoneal injection of DEX (25 μg/kg) was administered 30 min prior to the induction of I/R. The results indicate that in the I/R rats, DEX played a protective role by reducing the damage to the tubules and maintaining renal function. Furthermore, in response to I/R, the DEX treatment reduced the mRNA expression of TNF-α, IL-1β, IL-6, and MCP-1 in the kidney tissues and the serum levels of TNF-α, IL-1β, IL-6, and MCP-1. DEX also reduced the levels of oxidative stress and apoptosis in the tubular cells. These results indicate that in response to I/R kidney injury, DEX plays a protective role by inhibiting inflammation and tubular cell apoptosis, reducing the production of reactive oxygen species, and promoting renal function.

Objective We conducted a meta‐analysis to evaluate the effects of prophylactic perioperative dexmedetomidine administration on postoperative junctional ectopic tachycardia (JET) and acute kidney injury (AKI) in pediatric patients having undergone cardiac surgery. Design This systematic review was registered with PROSPERO (CRD42017083880). Databases including PubMed, Cochrane Central Register of Controlled Trials, and Web of Science were searched for randomized controlled trials (RCTs) and observational cohort studies from its inception to March 2018. Two reviewers independently screened literature, extracted data, and assessed the quality of included studies using the Jadad scale and Newcastle‐Ottawa score. Meta‐analysis was then conducted by RevMan 5.3 and Stata 12.0 software. P value < .05 was considered significant. Results A total of nine eligible studies (5 RCTs and 4 observational studies) comprising 1851 patients were selected for the final analysis. The results of meta‐analysis showed that dexmedetomidine significantly reduced the incidence of postoperative JET (OR =0.35, 95% CI: 0.22 to 0.53, P < .00001), but there was no significant difference between groups in AKI (OR =0.44, 95% CI: 0.19 to 1.04, P = .06) and all‐cause mortality (OR =0.87, 95% CI: 0.35 to 2.14, P = .77). Conclusions The administration of perioperative dexmedetomidine effectively prevents JET in pediatric patients undergoing cardiac surgery but has no significant effect on postoperative renal function. However, the quality of evidence for these findings is low; thus, future larger scale randomized studies are needed to verify the real clinical effects of dexmedetomidine prophylaxis in pediatric patients.