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Effect of Combined Treatment of Ketorolac and Remote Ischemic Preconditioning on Renal Ischemia-Reperfusion Injury in Patients Undergoing Partial Nephrectomy: Pilot Study

Authors
 Hae Keum Kil  ;  Ji Young Kim  ;  Young Deuk Choi  ;  Hye Sun Lee  ;  Tae Kwang Kim  ;  Ji Eun Kim 
Citation
 Journal of Clinical Medicine, Vol.7(12) : E470, 2018 
Journal Title
 Journal of Clinical Medicine 
Issue Date
2018
Keywords
acute kidney injury ; ischemic preconditioning ; ketorolac
Abstract
We evaluated postoperative renal function in patients with/without combined therapy of ketorolac and remote ischemic preconditioning during partial nephrectomy. Sixteen patients were randomly allocated to either the ketorolac combined with RIPC group (KI, n = 8) or control group (n = 8). The KI group received both remote ischemic preconditioning before surgery and intravenous ketorolac of 1 mg/kg before renal artery clamping. Renal parameters were measured before induction, after anesthesia induction, and 2, 12, 24, 48, and 72 h after renal artery declamping. Acute kidney injury was assessed by Acute Kidney Injury Network criteria. The estimated glomerular filtration rate decreased in both groups, but then increased significantly at 48 h and 72 h after declamping only in the KI group compared to 24 h (p = 0.001 and p = 0.016). Additionally, it was higher at 48 h and 72 h after declamping in the KI group compared to the control group (p = 0.025 and p = 0.044). The incidence of acute kidney injury was significantly reduced in the KI group (13%) compared to the control group (83%) (p = 0.026). FENa was markedly increased at 2 h after declamping, and recovered in both groups, but it was more significant at 12 h after declamping in the KI group (p = 0.022). Urinary N-acetyl-1-β-D-glucosoaminidase and serum neutrophil gelatinase-associated lipocalin were similar (p = 0.291 and p = 0.818). There is a possibility that combined therapy of ketorolac and remote ischemic preconditioning prior to ischemia may alleviate renal dysfunction and reduce the incidence of acute kidney injury in patients undergoing partial nephrectomy.
Files in This Item:
T201805469.pdf Download
DOI
10.3390/jcm7120470
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Yonsei Biomedical Research Center (연세의생명연구원) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Urology (비뇨의학교실) > 1. Journal Papers
Yonsei Authors
김지영(Kim, Ji Young) ORCID logo https://orcid.org/0000-0001-5822-0338
이혜선(Lee, Hye Sun) ORCID logo https://orcid.org/0000-0001-6328-6948
최영득(Choi, Young Deuk) ORCID logo https://orcid.org/0000-0002-8545-5797
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/167298
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