Effect of remifentanil during cardiopulmonary bypass on incidence of acute kidney injury after cardiac surgery
- 265 Downloads
Acute kidney injury (AKI) after cardiopulmonary bypass (CPB) is a well-known postoperative complication. Remifentanil, which is a commonly used ultra-short-acting opioid, has antiinflammatory and sympatholytic effects with improvement of microcirculation.
A retrospective study was conducted to clarify the effect of the use of remifentanil during CPB on the incidence of postoperative AKI. Patients who underwent valve surgery while under cardiopulmonary bypass between January 2012 and December 2014 in our hospital were enrolled in this study. The incidences of postoperative AKI were compared in patients who received remifentanil during CPB (group R) and those who did not (group N). Univariate and multivariate regression analyses were performed to determine risk factors for AKI.
Eighty patients received remifentanil (group R) and 50 patients did not (group N). The incidences of AKI were not significantly different in group R and group N (51% vs. 36%, P = 0.10). In multivariate regression analysis, age [adjusted odds ratio (OR) 1.048, 95% CI 1.008–1.089, P = 0.017], male gender (adjusted OR 3.101, 95% CI 1.303–7.378, P = 0.011), and use of preoperative calcium channel blockers (adjusted OR 3.240, 95% CI 1.302–8.063, P = 0.011) and diuretics (adjusted OR 2.673, 95% CI 1.178–6.066, P = 0.019) were associated with the incidence of AKI. The use of remifentanil was not associated with AKI (adjusted OR 2.321, 95% CI 0.997–5.402, P = 0.051).
The use of remifentanil during CPB did not decrease the incidence of postoperative AKI after cardiac surgery.
KeywordsRemifentanil Acute kidney injury Cardiopulmonary bypass
Compliance with ethical standards
Conflict of interest
- 3.Hansen MK, Gammelager H, Jacobsen CJ, Hjortdal VE, Layton JB, Rasmussen BS, Andreasen JJ, Johnsen SP, Christiansen CF. Acute kidney injury and long-term risk of cardiovascular events after cardiac surgery: a population-based cohort study. J Cardiothorac Vasc Anesth. 2015;29:617–25.CrossRefPubMedGoogle Scholar
- 5.Karkouti K, Wijeysundera DN, Yau TM, Callum JL, Cheng DC, Crowther M, Dupuis JY, Fremes SE, Kent B, Laflamme C, Lamy A, Legare JF, Mazer CD, McCluskey SA, Rubens FD, Sawchuk C, Beattie WS. Acute kidney injury after cardiac surgery: focus on modifiable risk factors. Circulation. 2009;119:495–502.CrossRefPubMedGoogle Scholar
- 9.Winterhalter M, Brandl K, Rahe-Meyer N, Osthaus A, Hecker H, Hagl C, Adams HA, Piepenbrock S. Endocrine stress response and inflammatory activation during CABG surgery. A randomized trial comparing remifentanil infusion to intermittent fentanyl. Eur J Anaesthesiol. 2008;25:326–35.CrossRefPubMedGoogle Scholar
- 13.Demir A, Yılmaz FM, Ceylan C, Doluoglu OG, Uçar P, Züngün C, Guclu CY, Ünal U, Karadeniz U, Günertem E, Lafci G, Çağlı K, Özgök A. A comparison of the effects of ketamine and remifentanil on renal functions in coronary artery bypass graft surgery. Ren Fail. 2015;37:819–26.CrossRefPubMedGoogle Scholar
- 20.Parolari A, Pesce LL, Pacini D, Mazzanti V, Salis S, Sciacovelli C, Rossi F, Alamanni F, Monzino Research Group on Cardiac Surgery Outcomes. Risk factors for perioperative acute kidney injury after adult cardiac surgery: role of perioperative management. Ann Thorac Surg. 2012;93:584–91.CrossRefPubMedGoogle Scholar