title: 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.
abstract: BACKGROUND
  In this study we aimed to investigate the effects of dexmedetomidine on early stage renal function in pediatric patients undergoing cardiac angiography.
  
  
  METHODS
  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(-1) ketamine, 1 mg · kg(-1) propofol as bolus and followed by 1 mg · kg(-1) · h(-1) ketamine and 50 μg · kg(-1) · min(-1) propofol infusion. Additionally, a loading dose of 1 μg · kg(-1) dexmedetomidine given over 10 min followed by 0.5 μg · kg(-1) · h(-1) 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.
  
  
  RESULTS
  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 (P = 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( ) h in patients with CIN in both groups.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Medical Faculty, Department of Anesthesiology and Reanimation, Erciyes University, Kayseri, Turkey.
authors.forename: Adnan
authors.initials: A
authors.lastname: Bayram
authors.forename: Ayşe
authors.initials: A
authors.lastname: Ulgey
authors.forename: Ali
authors.initials: A
authors.lastname: Baykan
authors.forename: Nazmi
authors.initials: N
authors.lastname: Narin
authors.forename: Figen
authors.initials: F
authors.lastname: Narin
authors.forename: Aliye
authors.initials: A
authors.lastname: Esmaoglu
authors.forename: Adem
authors.initials: A
authors.lastname: Boyaci
mesh_terms: D062186:Arterial Pressure / Q000187:drug effects; D002675:Child, Preschool; D003287:Contrast Media; D017023:Coronary Angiography / Q000009:adverse effects* / Q000379:methods*; D020927:Dexmedetomidine / Q000009:adverse effects*; D004311:Double-Blind Method; D005260:Female; D006330:Heart Defects, Congenital / Q000601:surgery; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D006993:Hypnotics and Sedatives / Q000009:adverse effects*; D007223:Infant; D007668:Kidney / Q000187:drug effects*; D007677:Kidney Function Tests; D008297:Male; D011446:Prospective Studies
chemical_list: D003287:Contrast Media; D006993:Hypnotics and Sedatives; D020927:Dexmedetomidine
keywords: acute kidney injury; dexmedetomidine; endothelin-1; neutrophil gelatinase-associated lipocalin; renin