Anesthesia and Acute Kidney Injury After Nephrectomy

Study Overview
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Brief Summary
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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
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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.

Official Title
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The Influence of Type of Anesthesia on Postoperative Renal Function After Nephrectomy: a Randomized Controlled Study

Conditions
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Nephrectomy

Intervention / Treatment
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* Drug: Propofol
* Drug: Desflurane


Participation Criteria
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Eligibility Criteria
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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

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: TIVA group<br>Patients receiving the total intravenous anesthesia using propofol | Drug: Propofol<br>* The induction and maintenance of anesthesia was performed by total intravenous anesthesia using propofol. In both groups, remifentanil is continuously infused throughout the surgery.<br>|
| Active Comparator: Inhalation group<br>Patients receiving inhalation anesthesia using desflurane | Drug: Desflurane<br>* The induction and maintenance of anesthesia was performed by inhalation anesthesia using desflurane. In both groups, remifentanil is continuously infused throughout the surgery.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| the incidence of acute kidney injury | acute kidney injury (diagnosed by AKIN criteria) | during the postoperative seven days | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| serum creatinine | postoperative result of serum creatinine | postoperative day 1, 3, 14 | 
| estimated glomerular filtration rate | postoperative result of estimated glomerular filtration rate | postoperative day 1, 3, 14 | 
| biomarker of renal injury | postoperative result of biomarker of renal injury | postoperative day 1, 3, 14 | 
| the incidence of postoperative complications | urine leakage, prolonged ileus, wound infection, retroperitoneal abscess, pneumonia, reoperation, etc. | during the postoperative two weeks | 
| Length of hospital stay | length of hospital stay | during the postoperative two weeks | 
| Length of intensive care unit stay | length of intensive care unit stay | during the postoperative two weeks | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Anesthesia, Propofol, Inhaled anesthetics, Acute kidney injury, Nephrectomy