Introduction:
Acute kidney injury (AKI) is a serious complication that increases morbidity and mortality rates after coronary artery bypass grafting (CABG). Dexmedetomidine (DEX) is a selective α2-adrenergic agonist that has proven its efficacy as a cardioprotective agent. However, its impact on the kidneys is not yet well-established. This systematic review and meta-analysis aims to assess the impact of dexmedetomidine on reducing AKI risk in patients undergoing CABG.
Methods:
We conducted a systematic search in PubMed, Embase, and Scopus from inception until August 28th, 2024. We searched for all clinical trials and observational studies assessing the postoperative incidence of AKI or other adverse events in patients receiving DEX following CABG. Statistical analysis was performed using Review Manager 5.4, with a fixed-effects model applied unless significant heterogeneity was detected, in which case a random-effects model was used.
Results:
Eight studies involving a total of 1,133 patients were included in the meta-analysis. DEX was associated with a statistically significant reduction in postoperative AKI incidence (RR: 0.54, 95% CI [0.36, 0.81], p = 0.003). Moreover, a statistically significant difference was observed for the length of intensive care unit (ICU) stay (MD: -2.07, 95% CI [-3.33, -0.81], p = 0.001), hospital stay (MD: -0.59, 95% CI [-0.92, -0.25], p = 0.0006), and mechanical ventilation duration (MD: -1.74, 95% CI [-1.99, -1.49], p < 0.00001). However, no statistically significant difference was found for intra/post-operative hemorrhage (MD: -10.87, 95% CI [-29.87, 8.14], p = 0.26), or bradycardia (RR: 0.99, 95% CI [0.53, 1.84], p = 0.97).
Conclusions:
Dexmedetomidine appears to significantly reduce the incidence of AKI, ICU stay time, hospital stay, and mechanical ventilation duration in patients undergoing CABG. However, it does not significantly affect the rates of intra/post-operative hemorrhage or bradycardia. Further randomized controlled trials are recommended to assess the effects of different DEX doses on renal outcomes following CABG
I have no potential conflict of interest to disclose.
I did not use generative AI and AI-assisted technologies in the writing process.