The effect of dexmedetomidine on renal function in patients undergoing cardiac valve replacement under cardiopulmonary bypass: A double-blind randomized controlled trial

Effect of intraoperative dexmedetomidine on renal function after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy: a randomized, placebo-controlled trial

“…The length of ICU stay was also significantly reduced in the dexmedetomidine group. Previous randomized controlled trials on cardiac surgery with cardiopulmonary bypass have reported that perioperative infusion of dexmedetomidine reduced the incidence and severity of AKI [23][24][25]. Conversely, we could not find a meaningful impact of dexmedetomidine on CrCl and AKI incidences based on the increase of serum Cr in CRS and HIPEC.…”

“…However, the urinary levels of NGAL and KIM-1 were significantly less increased by dexmedetomidine. Such renal biomarkers were also shown to be affected or not affected by dexmedetomidine depending on the study [24][25][26]. This inconsistency could be attributed to differences in the degree of insults and responses arising from the nature of the surgery and patient-related risks.…”

“…Moreover, the protective mechanisms of these agents are mainly associated with cisplatin-induced nephrotoxicity. In contrast, dexmedetomidine has an experimental background and clinical experience upon the IR injury, inflammation and sympathetic excitation [17][18][19][20][21][22][23][24][25].…”

“…Dexmedetomidine showed an inhibitory effect on the excitement of the renal sympathetic nerves, leading to preserved renal perfusion and tubular function [20][21]; it reportedly attenuates renin secretion and increases glomerular filtration by activation of adrenoreceptors in the renal vasculature and tubules [21,22]. In conjunction, several randomized clinical trials on cardiac surgery have reported that perioperative dexmedetomidine infusion reduced the incidence and severity of acute kidney injury (AKI) [23][24][25]. In contrast, investigation on percutaneous nephrolithotomy revealed no benefit of dexmedetomidine except for reduced renin secretion [26].…”

Dexmedetomidina e anestesia para cirurgia cardíaca: revisão da literatura

“…O estudo concluiu que no grupo dexmedetomidina a incidência de IRA foi menor, enquanto o volume urinário foi maior, comparativamente ao grupo placebo. Além disso, os níveis de biomarcadores de injúria renal (creatinina, NGAL e BUN) analisados também foram menores no grupo da dexmedetomidine6 .Em relação à proteção cerebral com uso da dexmedetomidina, F. Kang et al realizaram uma pesquisa, publicada em 2018, na qual foram randomizados 97 participantes em dois grupos, comparando a anestesia com isoflurano associado à dexmedetomidina (0,6mcg/Kg em 15 minutos, seguido de manutenção de 0,2mcg/Kg/h) versus isoflurano isolado, em pacientes submetidos à troca valvar com CEC. Um possível efeito neuroproteteor desse alfa-2 agonista foi analisado através da quantificação sérica de biomarcadores de injúria cerebral (matrix metalloproteinase-9 -MMP-9; glial fibrillary acidic protein -GFAP; diferença do lactato arterial e venoso), coletados de amostras sanguíneas do bulbo carotídeo, em vários momentos do intraoperatório,incluindo o período de CEC.…”