Efecto del manejo analgésico perioperatorio con dipirona y/o diclofenaco en la incidencia de lesión renal aguda con requerimiento de terapia de reemplazo renal en pacientes llevados a cirugía de reemplazo articular en Colombia, un estudio retrospectivo
Autor: Ramirez Pimiento, Juan David
Asesor: Navarro Vargas, José Ricardo
Fecha: 2020-01-30
Programa: Bogotá - Medicina - Especialidad en Anestesiología y Reanimación
Facultad: Facultad de Medicina

Resumen: Dipyrone and diclofenac are common analgesics for joint replacement surgery. Nevertheless the risk of acute kidney injury associated to the use of NSAID might be higher in this population
Objective: to study the association between dipyrone, diclofenac or the combination of both for joint replacement surgery analgesia and the incidence of acute kidney injury that requires renal replacement therapy (RRT) and mortality.
Methods: A retrospective cohort study was made. Data was collected through a national database of procedures made in the contribute social security system and analysed with a logical regression model. 
Results: a total of 5078 procedures were obtained. Patients were divided by age, Charlson comorbidity Index (CCI) and geographic location of the procedure. After multivariate analysis an association was found between male gender, a higher CCI and the outcome of RRT; meanwhile male gender, older age and a higher CCI were all associated with a higher mortality. 
Conclusions: Adding dipyrone to diclofenac for perioperative analgesia doesn’t seem to increase the risk of RRT or mortality outcomes in patients taken for joint replacement surgery. However it is not possible to determine the safety of dipyrone in older and morbid patients in which diclofenac might be deleterious. Further studies are required to clarify whether dipyrone is safe when combined with NSAID. 
Key words: Dipyrone (Metamizole), Diclofenac, Acute kidney Injury, Dialysis, Arthroplasty,