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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.
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.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| TIVA group | Experimental | Patients receiving the total intravenous anesthesia using propofol |
|
| Inhalation group | Active Comparator | Patients receiving inhalation anesthesia using desflurane |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Propofol | Drug | The induction and maintenance of anesthesia was performed by total intravenous anesthesia using propofol. In both groups, remifentanil is continuously infused throughout the surgery. |
| Measure | Description | Time Frame |
|---|---|---|
| the incidence of acute kidney injury | acute kidney injury (diagnosed by KDIGO criteria) | during the postoperative seven days |
| 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 |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Seoul National University Hospital | Seoul | South Korea |
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| ID | Term |
|---|---|
| D058186 | Acute Kidney Injury |
| ID | Term |
|---|---|
| D051437 | Renal Insufficiency |
| D007674 | Kidney Diseases |
| D014570 | Urologic Diseases |
| D052776 | Female Urogenital Diseases |
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| ID | Term |
|---|---|
| D015742 | Propofol |
| D000077335 | Desflurane |
| ID | Term |
|---|---|
| D010636 | Phenols |
| D001555 | Benzene Derivatives |
| D006841 | Hydrocarbons, Aromatic |
| D006844 | Hydrocarbons, Cyclic |
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| Desflurane | Drug | The induction and maintenance of anesthesia was performed by inhalation anesthesia using desflurane. In both groups, remifentanil is continuously infused throughout the surgery. |
|
| 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 |
| D005261 |
| Female Urogenital Diseases and Pregnancy Complications |
| D000091642 | Urogenital Diseases |
| D052801 | Male Urogenital Diseases |
| D006838 |
| Hydrocarbons |
| D009930 | Organic Chemicals |
| D005019 | Ethyl Ethers |
| D004987 | Ethers |
| D008738 | Methyl Ethers |
| D006845 | Hydrocarbons, Fluorinated |
| D006846 | Hydrocarbons, Halogenated |