Anesthesia and Acute Kidney Injury After Nephrectomy

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

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.

Study Overview

• Status: Completed
• Conditions: Nephrectomy
• Intervention / Treatment: Drug: Propofol; Drug: 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.

• Study Type: Interventional
• Enrollment (Actual): 324
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Korea, Republic of
  • Seoul, Korea, Republic of
    • Seoul National University Hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No

Description

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

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Prevention
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Double

Number of Arms

2

Arms and Interventions

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

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
the incidence of acute kidney injury	acute kidney injury (diagnosed by KDIGO 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

Collaborators and Investigators

• Sponsor: Seoul National University Hospital

Study record dates

Study Major Dates

• Study Start (Actual): July 20, 2020
• Primary Completion (Actual): February 6, 2024
• Study Completion (Actual): March 6, 2024

Study Registration Dates

• First Submitted: July 7, 2020
• First Submitted That Met QC Criteria: July 14, 2020
• First Posted (Actual): July 17, 2020

Study Record Updates

• Last Update Posted (Estimated): December 2, 2024
• Last Update Submitted That Met QC Criteria: November 27, 2024
• Last Verified: November 1, 2024

More Information

Terms related to this study

• Keywords: Propofol; Anesthesia; Nephrectomy; Acute kidney injury; Inhaled anesthetics
• Additional Relevant MeSH Terms: Urogenital Diseases; Male Urogenital Diseases; Kidney Diseases; Urologic Diseases; Female Urogenital Diseases; Female Urogenital Diseases and Pregnancy Complications; Renal Insufficiency; Acute Kidney Injury; Physiological Effects of Drugs; Anesthetics; Central Nervous System Depressants; Hypnotics and Sedatives; Anesthetics, Intravenous; Anesthetics, General; Anesthetics, Inhalation; Desflurane; Propofol
• Other Study ID Numbers: Anesthetics_Nx_AKI

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No