The effects of dexmedetomidine on early stage renal functions in pediatric patients undergoing cardiac angiography using non-ionic contrast media: a double-blind, randomized clinical trial.
BACKGROUND
In this study we aimed to investigate the effects of dexmedetomidine on early stage renal function in pediatric patients undergoing cardiac angiography.


METHODS
60 pediatric patients between 6 and 72 months of age undergoing cardiac angiography were included in the study. Patients were divided into two groups. The patients in both groups were administered 1 mg · kg(-1) ketamine, 1 mg · kg(-1) propofol as bolus and followed by 1 mg · kg(-1) · h(-1) ketamine and 50 μg · kg(-1) · min(-1) propofol infusion. Additionally, a loading dose of 1 μg · kg(-1) dexmedetomidine given over 10 min followed by 0.5 μg · kg(-1) · h(-1) dexmedetomidine infusion to patients in group D. The patients were evaluated for NGAL, creatinine, renin, endothelin-1, TAS and TOS blood levels before the procedure and 6th and 24th h after the procedure. pRIFLE criteria were used to define CIN and its incidence in the study.


RESULTS
According to pRIFLE criteria contrast-induced acute kidney injury developed in 3 (10%) of the patients in group D and 11 (36.7%) of the patients in group C (P = 0.029, risk ratio = 0.27; 95% CI: 0.084-0.88). In patients who developed CIN, Endothelin-1 levels in groups C and D were significantly higher than baseline levels at 6th, 24th and 6th h, respectively. Renin levels were significantly increased at 6th and 24 th( ) h in patients with CIN in both groups.


CONCLUSIONS
Dexmedetomidine may be beneficial in protecting against contrast-induced nephropathy during pediatric angiography by preventing the elevation of vasoconstrictor agents such as plasma endothelin-1 and renin.
['Bayram|Adnan|A|', 'Ulgey|Ayşe|A|', 'Baykan|Ali|A|', 'Narin|Nazmi|N|', 'Narin|Figen|F|', 'Esmaoglu|Aliye|A|', 'Boyaci|Adem|A|']
D062186:Arterial Pressure D002675:Child, Preschool D003287:Contrast Media D017023:Coronary Angiography D020927:Dexmedetomidine D004311:Double-Blind Method D005260:Female D006330:Heart Defects, Congenital D006339:Heart Rate D006801:Humans D006993:Hypnotics and Sedatives D007223:Infant D007668:Kidney D007677:Kidney Function Tests D008297:Male D011446:Prospective Studies
dexmedetomidine renin endothelin-1 acute kidney injury neutrophil gelatinase-associated lipocalin