The Protective Effects Of Dexmedetomidine On Renal Function In Patients Undergoing Double Valve Replacement Surgery With Cardiopulmonary Bypass

Objective:To evaluate the possible protective effects of dexmedetomidine on renal function in patients undergoing Double valve replacement surgery with cardiopulmonary bypass.Measurements:Eighty-six patients undergoing Double valve replacement surgery with cardiopulmonary bypass were enrolled and randomly assigned to two groups.Dex group (Group A, n=43) received a loading dose of0.5μg/kg for10min followed by a continuous IV infusion at0.5μg/kg/h till the end of the surgery.The control group received a loading dose and continuous infusion of saline at the same rate.Conventional treatments of the two groups were received in the same way.Blood urea nitrogen (BUN),Serum creatinine (Scr)and serum cystatin C were determined preoperation(T0)、days1(T1)、2(T2)、3(T3)、7(T4)post operation.The incidence of AKI together with the correlations between AKI and the biomarkers were also recorded.Results:BUN、Scr levels of the two groups demonstrated a rise and reached a peak value on day3postoperatively(T3time piont), and the trend in Group A was increased slowly than Group B.Patients in the two groups had significantly greater BUN、Scr levels than preoperative levels at postoperative day2and day3. The trend declined after T3time point and gradually approached the preoperative levels on day7after surgery.Also,Patients in the Dex group had significantly greater BUN、 Scr levels than the control group at postoperative day2and day3.Cys-C levels demonstrated a rise and reached a peak value on day2postoperatively, and also the trend in Group A was increased slowly than Group B.Patients in the two groups had significantly greater Cys-C levels than preoperative levels at T1、T2and T3time points.The trend declined after T2time point and gradually approached the preoperative levels on day7after surgery.Also,Patients in the Dex group had significantly greater Cys-C levels than the control group at postoperative T1、T2and T3time points. AKI developed in14of43(32.6%) patients receiving Dex and in27of43(62.8%) patients receiving saline (p<0.05).Cys-C levels had the most significantly associated with AKI than the other two biomarkers, with OR(95%CI) of2.42(0.99-5.92).Conclusions:Dex had significantly decreased BUN、Scr and serum Cys-C levels;and had a potential protective effects of renal function in patients undergoing double valve replacement surgery with cardiopulmonary bypass.