{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T09:50:37Z","timestamp":1791453037253,"version":"4.3.3"},"reference-count":0,"publisher":"The Korean Society of Anesthesiologists","content-domain":{"domain":["anesth-pain-med.org"],"crossmark-restriction":true},"short-container-title":["Anesth Pain Med"],"abstract":"<jats:p>Background: Rocuronium and sugammadex are used cautiously in patients with chronic kidney disease (CKD) undergoing anesthesia because of delayed excretion. This multicenter retrospective study explored the safety and recovery of rocuronium\u2013sugammadex compared to cisatracurium\/atracurium\u2013pyridostigmine in patients with CKD.Methods: Patients with CKD who received rocuronium\u2013sugammadex (RS group) or cisatracurium\/atracurium\u2013pyridostigmine (CP group) between 2020 and 2021 at three tertiary referral hospitals were included. Propensity score-matching was performed using a logistic regression model. The primary outcomes were safety-related indicators (e.g., reintubation, deferred extubation, and desaturation). Secondary outcomes included recovery-related profiles (e.g., extubation time). Subgroup analyses were conducted according to the CKD stage.Results: Of the total 1,241 patients (RS = 630, CP = 611), 804 (402 per group) were matched and analyzed. Among them, 51.1% had advanced CKD (estimated glomerular filtration rate &lt; 30 ml\/min\/1.73 m2). Primary safety outcomes, including the incidence of reintubation within 48 h (RS: 1.24% vs. CP: 1.24%, P = 1.000) and deferred extubation (1.74% vs. 1.49%, P = 0.780), were not significantly different. Postoperative desaturation and renal outcomes were similar between groups. Extubation time was shorter in the RS group than in the CP group (median 7.00vs. 8.00 min, P = 0.005).Conclusions: Rocuronium\u2013sugammadex demonstrated no clear signal of increased major respiratory or renal risk compared with cisatracurium\/atracurium\u2013pyridostigmine in patients with CKD. Although the extubation time was shorter in the RS group, this exploratory finding must be interpreted cautiously because of the heterogeneous practice and limited quantitative neuromuscular monitoring (22%).<\/jats:p>","DOI":"10.17085\/apm.25496","type":"journal-article","created":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T09:02:17Z","timestamp":1791450137000},"update-policy":"https:\/\/doi.org\/10.17085\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Safety and recovery of rocuronium and sugammadex versus cisatracurium or atracurium and pyridostigmine in surgical patients with chronic kidney disease: a multi-center retrospective propensity score-matched study"],"prefix":"10.17085","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1702-3180","authenticated-orcid":true,"given":"Doyeop","family":"Lee","sequence":"first","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2939-1848","authenticated-orcid":true,"given":"Seok Kyeong","family":"Oh","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4754-9776","authenticated-orcid":true,"given":"Heezoo","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-7649-4151","authenticated-orcid":true,"given":"Seokwoo","family":"Jeong","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2738-8573","authenticated-orcid":true,"given":"Eun-Su","family":"Choi","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0565-6802","authenticated-orcid":true,"given":"Eun Ji","family":"Ko","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3302-1831","authenticated-orcid":true,"given":"Byung Gun","family":"Lim","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2573","published-online":{"date-parts":[[2026,10,8]]},"container-title":["Anesthesia and Pain Medicine"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/anesth-pain-med.org\/upload\/pdf\/apm-25496.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T09:02:18Z","timestamp":1791450138000},"score":1,"resource":{"primary":{"URL":"http:\/\/anesth-pain-med.org\/journal\/view.php?doi=10.17085\/apm.25496"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,8]]},"references-count":0,"URL":"https:\/\/doi.org\/10.17085\/apm.25496","relation":{},"ISSN":["1975-5171","2383-7977"],"issn-type":[{"value":"1975-5171","type":"print"},{"value":"2383-7977","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,8]]},"assertion":[{"value":"2025-12-23","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-09","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-08","order":2,"name":"published","label":"Published online","group":{"name":"publication_history","label":"Publication History"}}]}}