The Role of Dexmedetomidine for the Prevention of Acute Kidney Injury in Critical Care

Abstract

Acute kidney injury (AKI) occurs in up to 50% of patients admitted to the intensive care unit and is associated with increased mortality. Currently, there is no effective pharmacotherapy for prevention or treatment of AKI. In animal models of sepsis and ischaemia-reperfusion, α2-agonists like dexmedetomidine (DEX) exhibit anti-inflammatory properties and experimental data indicate a potential protective effect of DEX on renal function. However, clinical trials have yielded inconsistent results in critically ill patients. This review discusses the pathophysiological mechanisms involved in AKI, the renal effects of DEX in various intensive care unit-related conditions, and summarises the available literature addressing the use of DEX for the prevention of AKI.

Impact of dexmedetomidine on mortality in critically ill patients with acute kidney injury: a retrospective propensity score matching analysis

“…Overwhelming literature substantiates that DEX can alleviate AKI caused by several factors. Ruegg et al in a review summarised the role of DEX in preventing AKI in intensive care 26. Wang et al previously uncovered that DEX could ameliorate AKI in mice with sepsis by partially inhibiting oxidative stress and apoptosis by modulating the p75NTR/p38MAPK/JNK signalling pathways 27.…”

“…Ruegg et al in a review summarised the role of DEX in preventing AKI in intensive care. 26 Wang et al previously uncovered that DEX could ameliorate AKI in mice with sepsis by partially inhibiting oxidative stress and apoptosis by modulating the p75NTR/p38MAPK/JNK signalling pathways. 27 Zhao et al further substantiated that DEX protected against lipopolysaccharide-induced AKI by promoting autophagy mediated by PI3K/AKI/mTOR pathway inhibition.…”