title: Effects of Sugammadex and Neostigmine on Renal Biomarkers.
abstract: BACKGROUND
  Neostigmine, the currently commonly used agent for reversal of neuromuscular blockade. Sugammadex is a novel and unique compound designed as an antagonist of steroidal neuromuscular blockers. In this study, we evaluated the effects of sugammadex or neostigmine on kidney functions in patients scheduled for elective surgery.
  
  
  METHODS
  Patients scheduled for a surgical procedure under desflurane/opioid anesthesia received an intubating dose rocuronium. Patients were divided into 2 groups receiving either sugammadex or neostigmine atropine to reverse neuromuscular blockade. Cystatin C, creatinine, urea, blood urea nitrogen, sodium, potassium, and calcium levels in the blood and α1microglobulin, β2microglobulin, and microalbumin levels in the urine were measured.
  
  
  RESULTS
  There was no significant difference between the groups with regard to the demographic data. In the Neostigmine Group, although β2microglobulin and microalbumin were similar, a significant increase was found in the postoperative α1microglobulin and cystatin C values. In the Sugammadex Group, although β2-microglobulin and cystatin C were similar, a significant increase was found in the postoperative α1-microglobulin and microalbumin values. The only significant difference was cystatin C value variation in the Neostigmine Group compared to the Sugammadex Group.
  
  
  CONCLUSIONS
  We believe that the use of more specific and sensitive new-generation markers like cystatin C to evaluate kidney function will provide a better understanding and interpretation of our results. Sugammadex has more tolerable effects on kidney function in patients than does neostigmine. However, when compared to preoperative values, there is a negative alteration of postoperative values. Neostigmine and sugammadex do not cause renal failure but they may affect kidney function.
authors.affiliation: Department of Anesthesiology and Intensive Care, Izmir Katip Celebi University, Faculty of Medicine, Izmir, Turkey.
authors.forename: Yasemin
authors.initials: Y
authors.lastname: Isik
authors.affiliation: Department of Anesthesiology and Intensive Care, Sakarya University Training and Research Hospital, Sakarya, Turkey.
authors.forename: Onur
authors.initials: O
authors.lastname: Palabiyik
authors.affiliation: Department of Anesthesiology and Intensive Care, Yuzuncu Yil University, Faculty of Medicine, Van, Turkey.
authors.forename: Bilal Muhammed
authors.initials: BM
authors.lastname: Cegin
authors.affiliation: Department of Anesthesiology and Intensive Care, Yuzuncu Yil University, Faculty of Medicine, Van, Turkey.
authors.forename: Ugur
authors.initials: U
authors.lastname: Goktas
authors.affiliation: Department of Anesthesiology and Intensive Care, Gazi University, Faculty of Medicine, Ankara, Turkey.
authors.forename: Ismail
authors.initials: I
authors.lastname: Kati
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000378:metabolism*; D001794:Blood Pressure / Q000187:drug effects; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D007668:Kidney / Q000187:drug effects / Q000378:metabolism*; D008297:Male; D009388:Neostigmine / Q000494:pharmacology*; D000077122:Sugammadex; D047408:gamma-Cyclodextrins / Q000494:pharmacology*
chemical_list: D015415:Biomarkers; D047408:gamma-Cyclodextrins; D000077122:Sugammadex; D009388:Neostigmine