Nephrectomy
Conditions
Keywords
Anesthesia, Propofol, Inhaled anesthetics, Acute kidney injury, Nephrectomy
Brief summary
This study investigates the influence of type of anesthesia on postoperative renal dysfunction in patients undergoing nephrectomy. The participants will be allocated to either the group receiving the total intravenous anesthesia (TIVA) using propofol or the group receiving the inhaled anesthetics using desflurane.
Detailed description
Nephrectomy is considered as a standard therapy for renal cell carcinoma, but it can cause postoperative renal dysfunction, such as acute kidney injury and chronic kidney disease. Therefore, it is imperative to identify modifiable risk factors for postoperative acute kidney injury after nephrectomy in advance. According to a recent retrospective study, total intravenous anesthesia using propofol is significantly associated with lower incidence of acute kidney injury after nephrectomy, compared to the inhalation anesthesia. However, there is no prospective study which investigates the influence of type of anesthesia on postoperative renal function after nephrectomy. Therefore, in the present study, we aimed to investigate the influence of type of anesthesia on acute kidney injury after nephrectomy by performing randomized controlled study.
Interventions
DRUGPropofol
The induction and maintenance of anesthesia was performed by total intravenous anesthesia using propofol. In both groups, remifentanil is continuously infused throughout the surgery.
DRUGDesflurane
The induction and maintenance of anesthesia was performed by inhalation anesthesia using desflurane. In both groups, remifentanil is continuously infused throughout the surgery.
Sponsors
Seoul National University Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
DOUBLE (Subject, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Adults patients scheduled for elective open nephrectomy
Exclusion criteria
* Patients diagnosed with acute kidney injury preoperatively * Patients who have chronic kidney disease over stage 5 (estimated glomerular filtration rate \[eGFR\] \<15 ml/kg/1.73m2) or have regular hemodialysis preoperatively
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| the incidence of acute kidney injury | during the postoperative seven days | acute kidney injury (diagnosed by KDIGO criteria) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| estimated glomerular filtration rate | postoperative day 1, 3, 14 | postoperative result of estimated glomerular filtration rate |
| biomarker of renal injury | postoperative day 1, 3, 14 | postoperative result of biomarker of renal injury |
| serum creatinine | postoperative day 1, 3, 14 | postoperative result of serum creatinine |
| Length of hospital stay | during the postoperative two weeks | length of hospital stay |
| Length of intensive care unit stay | during the postoperative two weeks | length of intensive care unit stay |
| the incidence of postoperative complications | during the postoperative two weeks | urine leakage, prolonged ileus, wound infection, retroperitoneal abscess, pneumonia, reoperation, etc. |
Countries
South Korea
Outcome results
None listed