Renoprotective effect of perioperative dexmedetomidine in kidney transplant patients: systematic review and meta-analysis

Abstract

Objective To find whether dexmedetomidine has a renoprotective effect in kidney transplant patients. Methods We electronically searched Embase, PubMed, and the Cochrane Library from create database through September 10, 2022. Including studies compared dexmedetomidine and placebo in kidney transplant patients. Extract outcomes contain the incidence of delayed graft function (DGF), acute rejection, length of hospital stay (LOS), post-transplantation 2-day SCr and post-transplantation 7-day SCr. We use Stata SE 15 software to conduct meta-analysis. All outcome were used random effects models. The continuous data and categorical date respectively reported use weighted mean difference (WMD) and odds ratio (OR) with 95% confidence interval. Results This meta-analysis including four RCTS and one cohort study. The incidence of DGF were lower in dexmedetomidine group than placebo (OR 0.71, 95%CI 0.52–0.97, P = 0.032). Dexmedetomidine significant improve in Post-transplantation 2-day SCr than placebo (WMD=-0.36 95% CI -0.68–0.05, P = 0.024). Other outcomes were no significant effect compared with placebo. Conclusion Perioperative dexmedetomidine infusion can reduce the incidence of DGF and have a protective effect on renal function at least in the early postoperative period. Due to the limited number of included studies, the above conclusions need to be verified by more high-quality studies.