The effects of dexmedetomidine on early stage renal functions in pediatric patients undergoing cardiac angiography using non‐ionic contrast media: a double‐blind, randomized clinical trial. Issue 4 (13th January 2014)

• Record Type: Journal Article
• Authors: Bayram, Adnan; Ülgey, Ayşe; Baykan, Ali; Narin, Nazmi; Narin, Figen; Esmaoglu, Aliye; Boyaci, Adem; Hammer, Greg
• Is Part Of: Paediatric anaesthesia. Volume 24:Issue 4(2014)
• Page Start: 426
• Page End: 432
• Publication Date: 2014-01-13
• Subjects: Pediatric anesthesia -- Periodicals; 617.96798
• DOI: 10.1111/pan.12348
• Languages: English
• ISSNs: 1155-5645

Abstract

<abstract abstract-type="main" id="pan12348-abs-0001"> <title>Summary</title> <sec id="pan12348-sec-0001" sec-type="section"> <title>Background</title> <p>In this study we aimed to investigate the effects of dexmedetomidine on early stage renal function in pediatric patients undergoing cardiac angiography.</p> </sec> <sec id="pan12348-sec-0002" sec-type="section"> <title>Methods</title> <p>60 pediatric patients between 6 and 72 months of age undergoing cardiac angiography were included in the study. Patients were divided into two groups. The patients in both groups were administered 1 mg·kg<sup>−1</sup> ketamine, 1 mg·kg<sup>−1</sup> propofol as bolus and followed by 1 mg·kg<sup>−1</sup>·h<sup>−1</sup> ketamine and 50 μg·kg<sup>−1</sup>·min<sup>−1</sup> propofol infusion. Additionally, a loading dose of 1 μg·kg<sup>−1</sup> dexmedetomidine given over 10 min followed by 0.5 μg·kg<sup>−1</sup>·h<sup>−1</sup> dexmedetomidine infusion to patients in group D. The patients were evaluated for NGAL, creatinine, renin, endothelin‐1, TAS and TOS blood levels before the procedure and 6th and 24th h after the procedure. pRIFLE criteria were used to define CIN and its incidence in the study.</p> </sec> <sec id="pan12348-sec-0003" sec-type="section"> <title>Results</title> <p>According to pRIFLE criteria contrast‐induced acute kidney injury developed in 3 (10%) of the patients in group D and 11 (36.7%) of the patients in group C (<italic>P</italic> = 0.029, risk ratio = 0.27; 95% CI: 0.084–0.88). In patients who developed CIN, Endothelin‐1 levels in groups C and D were significantly higher than baseline levels at 6th, 24th and 6th h, respectively. Renin levels were significantly increased at 6th and 24 th<sup> </sup>h in patients with CIN in both groups.</p> </sec> <sec id="pan12348-sec-0004" sec-type="section"> <title>Conclusions</title> <p>Dexmedetomidine may be beneficial in protecting against contrast‐induced nephropathy during pediatric angiography by preventing the elevation of vasoconstrictor agents such as plasma endothelin‐1 and renin.</p> </sec> </abstract>