title: Post-bypass dexmedetomidine use and postoperative acute kidney injury in patients undergoing cardiac surgery with cardiopulmonary bypass.
abstract: BACKGROUND
  AND OBJECTIVES: The aim of this retrospective investigation was to study the relationships among chronic kidney disease, acute kidney injury (AKI), and potential benefits by post-bypass dexmedetomidine use in patients undergoing cardiac surgery.
  
  
  METHODS
  The patient data were reviewed from the institutional Society of Thoracic Surgeons National Adult Cardiac Surgery Database after IRB approval. 1,133 patients were identified and divided into two groups: those who received dexmedetomidine or those who did not during the post-bypass period. The postoperative outcomes include the incidence of AKI, any complication and all cause of mortality.
  
  
  RESULTS
  Post-bypass dexmedetomidine use was associated with significantly reduced the incidence of total AKI (26.1% vs. 33.75%; adjusted OR, 0.7033; 95%CI, 0.540 to 0.916; p=0.0089). In addition, post-bypass dexmedetomidine use was more likely to reduce the incidence of AKI in these patients with preoperative normal kidney function (Stage1; 32.8% to 22.8%; p=0.0233) and mild CKD (Stage 2; 32.8% to 24.7; p=0.0003) after cardiac surgery. Post-bypass infusion of dexmedetomidine was associated with significantly reduced incidence of any complication and 30-day mortalities.
  
  
  CONCLUSIONS
  Post-bypass dexmedetomidine use is associated with a significant reduction in the incidence of AKI, especially mild AKI in patients with preoperative normal renal function and mild CKD undergoing cardiac surgery.
authors.affiliation: Department of Anesthesiology, First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China ; Department of Anesthesiology and Pain Medicine, University of California Davis Health System, Sacramento, California, United States of America.
authors.forename: Fuhai
authors.initials: F
authors.lastname: Ji
authors.forename: Zhongmin
authors.initials: Z
authors.lastname: Li
authors.forename: J Nilas
authors.initials: JN
authors.lastname: Young
authors.forename: Artin
authors.initials: A
authors.lastname: Yeranossian
authors.forename: Hong
authors.initials: H
authors.lastname: Liu
mesh_terms: D058186:Acute Kidney Injury / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control*; D058647:Adrenergic alpha-2 Receptor Agonists / Q000627:therapeutic use*; D000368:Aged; D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D002315:Cardiopulmonary Bypass / Q000009:adverse effects*; D020927:Dexmedetomidine / Q000627:therapeutic use*; D006801:Humans; D015994:Incidence; D007668:Kidney / Q000187:drug effects / Q000503:physiopathology; D008297:Male; D011183:Postoperative Complications / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control*; D011184:Postoperative Period; D051436:Renal Insufficiency, Chronic / Q000150:complications; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D058647:Adrenergic alpha-2 Receptor Agonists; D020927:Dexmedetomidine