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Effect of remifentanil during cardiopulmonary bypass on incidence of acute kidney injury after cardiac surgery

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A Letter to the Editor to this article was published on 28 March 2018

A Letter to the Editor to this article was published on 11 January 2018

Abstract

Background

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.

Methods

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.

Results

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).

Conclusion

The use of remifentanil during CPB did not decrease the incidence of postoperative AKI after cardiac surgery.

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Authors and Affiliations

  1. Department of Anesthesiology, Asahikawa City Hospital, Kinseicho 1-1-65, Asahikawa, Hokkaido, 070-8610, Japan

    Wataru Sakai

  2. Department of Anesthesiology, Sapporo Medical University Hospital, South 1, West 16, Chuo-ku, Sapporo, Hokkaido, 060-8543, Japan

    Yusuke Yoshikawa, Naoyuki Hirata & Michiaki Yamakage

Authors
  1. Wataru Sakai
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  2. Yusuke Yoshikawa
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  3. Naoyuki Hirata
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  4. Michiaki Yamakage
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Correspondence to Yusuke Yoshikawa or Naoyuki Hirata.

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Sakai, W., Yoshikawa, Y., Hirata, N. et al. Effect of remifentanil during cardiopulmonary bypass on incidence of acute kidney injury after cardiac surgery. J Anesth 31, 895–902 (2017). https://doi.org/10.1007/s00540-017-2419-y

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  • DOI: https://doi.org/10.1007/s00540-017-2419-y

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