In reply: Why remifentanil?
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To the Editor:
We wish to thank Dr. Lema G for his comments on our article .
Based on the anti-inflammatory and sympathoinhibitory effects of remifentanil, we considered that remifentanil might have a renal protective effect against acute kidney injury (AKI) after cardiac surgery with cardiopulmonary bypass (CPB). Additionally, a recent article showed that remifentanil had a renal protective effect against ischemic-reperfusion injury in rat experimental models . However, our results were not able to reveal that. One possible reason is that the amount of remifentanil administered in our cohort was not enough. Since the association between dose of remifentanil and AKI has not been evaluated yet, further studies will be required.
As Dr. Lema G mentioned, most of the patients in our study had almost normal renal function. A retrospective study showed the possibility that remifentanil could improve renal function of patients with chronic kidney disease (CKD) temporarily after general surgery . If the renoprotective effect of remifentanil had been investigated in patients with CKD, the results might have been different.
We are indebted to Naoyuki Hirata M.D., Ph.D. for critical reading of this manuscript.
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Conflict of interest
The authors declare that they have interest and nothing to disclose.