Perioperative effects of dexmedetomidine on renal function in allogeneic kidney transplant patients: a meta-analysis.
Guo, Y., et al.International Urology & Nephrology 2025 [record in progress].
Aims
The aim of this study was to synthesise the available evidence on the role of dexmedetomidine on perioperative renal function in allogeneic renal transplant recipients.
Interventions
PubMed, Embase, Cochrane Library, Web of Science and the China National Knowledge Infrastructure (CNKI) were searched for relevant literature. Data were extracted by two independent reviewers. The Cochrane Risk of Bias Tool was used to assess the methodogical quality of randomised controlled trials and the Newcastle–Ottawa Scale (NOS) was used for observational studies.
Participants
11 studies were included in the review.
Outcomes
The primary outcomes were levels of serum creatinine (Cr), blood urea, nitrogen (BUN), urine output, and the incidence of delayed graft function. Secondary outcomes were length of hospital stay and perioperative adverse efects.
Follow-up
N/A
CET Conclusions
Dexmedetomidine, a highly selective a2-adrenegic agonist used as a sedative in peri-operative care has been shown to have renoprotective effects and reduces the rate of post-operative acute kidney injury (AKI) in various surgical settings. The efficacy data in the context of kidney transplantation (KT) however, has been mixed. This systematic review and meta-analysis synthesised the available data analysing the efficacy of dexmedetomidine in the peri-operative care of KT patients. The primary outcomes were urea and creatinine levels, and rate of delayed graft function (DGF). 11 studies comprising 1417 patients were included in the analysis. Most of the studies were randomised trials, with 10 of the studies originating from the far east. No direct assessment of bias analysis was conducted but the authors highlighted the significant risk of publication bias. The pooled results showed significant improvements in all 3 primary outcomes. However, there was no timeframe specified and, with other studies (not included in this meta-analysis) showing that there is no benefit after 30 days post-operatively, this is an important omission. Finally, no subgroup analysis (such as living vs deceased donor) nor reporting of adverse events were included, decreasing the clinical utility of this meta-analysis.
Trial registration
N/A