title: Anesthetics influence the incidence of acute kidney injury following valvular heart surgery.
abstract: Propofol has been shown to provide protection against renal ischemia/reperfusion injury experimentally, but clinical evidence is lacking. Here we studied the effect of propofol anesthesia on the occurrence of acute kidney injury following heart surgery with cardiopulmonary bypass. One hundred and twelve patients who underwent valvular heart surgery were randomized to receive either propofol or sevoflurane anesthesia, both with sufentanil. Using Acute Kidney Injury Network criteria, significantly fewer patients developed acute kidney injury postoperatively in the propofol group compared with the sevoflurane group (6 compared with 21 patients). The incidence of severe renal dysfunction was significantly higher in the sevoflurane group compared with the propofol group (5 compared with none). The postoperative cystatin C was significantly lower in the propofol group at 24 and 48 h. Serum interleukin-6 at 6 h after aorta cross-clamp removal, C-reactive protein at postoperative day 1, and segmented neutrophil counts at postoperative day 3 were also significantly lower in the propofol group. Thus, propofol anesthesia significantly reduced the incidence and severity of acute kidney injury in patients undergoing valvular heart surgery with cardiopulmonary bypass compared with sevoflurane. This beneficial effect of propofol may be related to its ability to attenuate the perioperative increase in proinflammatory mediators.
authors.affiliation: 1] Department of Anesthesiology and Pain Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea [2] Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Young-Chul
authors.initials: YC
authors.lastname: Yoo
authors.affiliation: 1] Department of Anesthesiology and Pain Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea [2] Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Jae-Kwang
authors.initials: JK
authors.lastname: Shim
authors.affiliation: 1] Department of Anesthesiology and Pain Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea [2] Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Young
authors.initials: Y
authors.lastname: Song
authors.affiliation: Department of Anesthesiology and Pain Medicine, Chung-Ang University College of Medicine, Seoul, Republic of Korea.
authors.forename: So-Young
authors.initials: SY
authors.lastname: Yang
authors.affiliation: 1] Department of Anesthesiology and Pain Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea [2] Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea [3] Severance Biomedical Science Institute, Yonsei University Health System, Seoul, Republic of Korea.
authors.forename: Young-Lan
authors.initials: YL
authors.lastname: Kwak
mesh_terms: D058186:Acute Kidney Injury / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control*; D000368:Aged; D018681:Anesthetics, General / Q000009:adverse effects* / Q000627:therapeutic use*; D018685:Anesthetics, Inhalation / Q000009:adverse effects / Q000627:therapeutic use; D018686:Anesthetics, Intravenous / Q000009:adverse effects / Q000627:therapeutic use; D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D002315:Cardiopulmonary Bypass / Q000009:adverse effects; D005260:Female; D006349:Heart Valve Diseases / Q000601:surgery*; D006801:Humans; D015994:Incidence; D008297:Male; D008738:Methyl Ethers / Q000009:adverse effects / Q000627:therapeutic use; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D015742:Propofol / Q000009:adverse effects / Q000627:therapeutic use; D011446:Prospective Studies; D056910:Republic of Korea / Q000453:epidemiology; D000077149:Sevoflurane; D017409:Sufentanil / Q000009:adverse effects / Q000627:therapeutic use
chemical_list: D018681:Anesthetics, General; D018685:Anesthetics, Inhalation; D018686:Anesthetics, Intravenous; D008738:Methyl Ethers; D000077149:Sevoflurane; D017409:Sufentanil; D015742:Propofol