{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T16:23:04Z","timestamp":1793290984942,"version":"4.5.0"},"reference-count":49,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,5,24]],"date-time":"2024-05-24T00:00:00Z","timestamp":1716508800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Postoperative acute kidney injury (AKI) is a serious and distressing complication connected to various adverse outcomes following the surgical operation. Controversy remains regarding the dexmedetomidine\u2019s preventive impact on postoperative AKI. Therefore, this investigation aims to explore the efficiency and safety of dexmedetomidine in preventing AKI after surgical operation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We systematically searched electronic databases such as PubMed, Embase, Web of Science, and the Cochrane Library to detect eligible randomized controlled studies that used dexmedetomidine for the prevention of AKI following operation up to April 30, 2023. The main outcome evaluated was AKI incidence. The evidence quality was assessed employing the Grading of Recommendations Assessment, Development, and Evaluation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The meta-analysis included 25 trials, including 3,997 individuals. Of these, 2,028 were in the dexmedetomidine group, and 1,969 were in the control group. The result showed that patients administered dexmedetomidine significantly decreased the AKI incidence following surgical operation in contrast to the control group (risk ratio, 0.60; 95% confidence intervals, 0.45\u20130.78; <jats:italic>p<\/jats:italic>\u2009&amp;lt;\u20090.05; <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup>\u2009=\u200946%). In addition, dexmedetomidine decreased the period of hospitalization in both the intensive care unit (ICU) and the hospital while also reducing postoperative delirium (POD) occurrence. However, dexmedetomidine elevated the incidence of bradycardia but did not have a significant impact on other indicators.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our meta-analysis indicates that the dexmedetomidine treatment reduces the postoperative AKI and POD risk while also shortening the time of hospitalization in the ICU and hospital. However, it is connected to an increased bradycardia risk.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fmed.2024.1414794","type":"journal-article","created":{"date-parts":[[2024,5,24]],"date-time":"2024-05-24T04:40:26Z","timestamp":1716525626000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":7,"title":["The effectiveness of dexmedetomidine for preventing acute kidney injury after surgery: a systematic review and meta-analysis"],"prefix":"10.3389","volume":"11","author":[{"given":"Jing","family":"Zhao","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ming-hao","family":"Tang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qi-hong","family":"Shen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ding-chao","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2024,5,24]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"c3365","DOI":"10.1136\/bmj.c3365","article-title":"Perioperative acute kidney injury: risk factors, recognition, management, and outcomes","volume":"341","author":"Borthwick","year":"2010","journal-title":"BMJ"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"e008834","DOI":"10.1161\/JAHA.118.008834","article-title":"Cardiac and vascular surgery-associated acute kidney injury: the 20th international consensus conference of the ADQI (acute disease quality initiative)","volume":"7","author":"Nadim","year":"2018","journal-title":"Group J Am Heart Assoc"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"1229","DOI":"10.1213\/ANE.0000000000003576","article-title":"Association between intraoperative oliguria and acute kidney injury after major noncardiac surgery","volume":"127","author":"Shiba","year":"2018","journal-title":"Anesth Analg"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"R79","DOI":"10.1186\/cc7894","article-title":"Determinants of postoperative acute kidney injury","volume":"13","author":"Abelha","year":"2009","journal-title":"Crit Care"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"916","DOI":"10.1213\/ANE.0b013e31828175ab","article-title":"The association of preoperative statin use and acute kidney injury after noncardiac surgery","volume":"117","author":"Argalious","year":"2013","journal-title":"Anesth Analg"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"120","DOI":"10.1016\/j.jcrc.2016.05.012","article-title":"Postoperative acute kidney injury in high-risk patients undergoing major abdominal surgery","volume":"35","author":"Romagnoli","year":"2016","journal-title":"J Crit Care"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"521","DOI":"10.1007\/s00134-015-4157-7","article-title":"Incidence and associations of acute kidney injury after major abdominal surgery","volume":"42","author":"O'Connor","year":"2016","journal-title":"Intensive Care Med"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"500","DOI":"10.2215\/CJN.07830814","article-title":"AKI associated with cardiac surgery","volume":"10","author":"Thiele","year":"2015","journal-title":"Clin J Am Soc Nephrol"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"109959","DOI":"10.1016\/j.intimp.2023.109959","article-title":"Dexmedetomidine attenuates hepatic ischemia-reperfusion injury-induced apoptosis via reducing oxidative stress and endoplasmic reticulum stress","volume":"117","author":"Zhang","year":"2023","journal-title":"Int Immunopharmacol"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"110498","DOI":"10.1016\/j.jclinane.2021.110498","article-title":"Dexmedetomidine reduces acute kidney injury after endovascular aortic repair of Stanford type B aortic dissection: a randomized, double-blind, placebo-controlled pilot study","volume":"75","author":"Shan","year":"2021","journal-title":"J Clin Anesth"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"118004","DOI":"10.1016\/j.lfs.2020.118004","article-title":"Dexmedetomidine pretreatment attenuates myocardial ischemia reperfusion induced acute kidney injury and endoplasmic reticulum stress in human and rat","volume":"257","author":"Tang","year":"2020","journal-title":"Life Sci"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"n71","DOI":"10.1136\/bmj.n71","article-title":"The PRISMA 2020 statement: an updated guideline for reporting systematic reviews","volume":"372","author":"Page","year":"2021","journal-title":"BMJ"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"1075","DOI":"10.1097\/ALN.0b013e3181b6a783","article-title":"Prevalence of delirium with dexmedetomidine compared with morphine based therapy after cardiac surgery: a randomized controlled trial (DEXmedetomidine COmpared to morphine-DEXCOM study)","volume":"111","author":"Shehabi","year":"2009","journal-title":"Anesthesiology"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1186\/1471-2253-11-9","article-title":"Renal effects of dexmedetomidine during coronary artery bypass surgery: a randomized placebo-controlled study","volume":"11","author":"Leino","year":"2011","journal-title":"BMC Anesthesiol"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"249","DOI":"10.5090\/kjtcs.2014.47.3.249","article-title":"Efficacy and safety of dexmedetomidine for postoperative delirium in adult cardiac surgery on cardiopulmonary bypass","volume":"47","author":"Park","year":"2014","journal-title":"Kor J Thora Cardiovasc Surg"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"1055","DOI":"10.1093\/bja\/aeu132","article-title":"Dexmedetomidine reduces intestinal and hepatic injury after hepatectomy with inflow occlusion under general anaesthesia: a randomized controlled trial","volume":"112","author":"Wang","year":"2014","journal-title":"Br J Anaesth"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"209","DOI":"10.1093\/icvts\/ivu367","article-title":"The dose-related effects of dexmedetomidine on renal functions and serum neutrophil gelatinase-associated lipocalin values after coronary artery bypass grafting: a randomized, triple-blind, placebo-controlled study","volume":"20","author":"Balkanay","year":"2015","journal-title":"Interact Cardiovasc Thorac Surg"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"395","DOI":"10.4103\/1658-354X.177340","article-title":"Cardiac and renal protective effects of dexmedetomidine in cardiac surgeries: a randomized controlled trial","volume":"10","author":"Ammar","year":"2016","journal-title":"Saudi J Anaesth"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"693","DOI":"10.1038\/ki.2015.306","article-title":"Perioperative dexmedetomidine reduces the incidence and severity of acute kidney injury following valvular heart surgery","volume":"89","author":"Cho","year":"2016","journal-title":"Kidney Int"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"362","DOI":"10.1097\/ALN.0000000000000951","article-title":"Dexmedetomidine versus Propofol sedation reduces delirium after cardiac surgery: a randomized controlled trial","volume":"124","author":"Djaiani","year":"2016","journal-title":"Anesthesiology"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"298","DOI":"10.1186\/s13054-016-1480-5","article-title":"Dexmedetomidine sedation reduces atrial fibrillation after cardiac surgery compared to propofol: a randomized controlled trial","volume":"20","author":"Liu","year":"2016","journal-title":"Crit Care"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"606","DOI":"10.4103\/0971-9784.191570","article-title":"The myocardial protective effect of dexmedetomidine in high-risk patients undergoing aortic vascular surgery","volume":"19","author":"Soliman","year":"2016","journal-title":"Ann Card Anaesth"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"e7480","DOI":"10.1097\/MD.0000000000007480","article-title":"The effect of intraoperative dexmedetomidine on acute kidney injury after pediatric congenital heart surgery: a prospective randomized trial","volume":"96","author":"Jo","year":"2017","journal-title":"Medicine"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"e0170757","DOI":"10.1371\/journal.pone.0170757","article-title":"Impact of dexmedetomidine on the incidence of delirium in elderly patients after cardiac surgery: a randomized controlled trial","volume":"12","author":"Li","year":"2017","journal-title":"PLoS One"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"408","DOI":"10.4103\/aca.ACA_57_17","article-title":"Comparison of the renoprotective effect of dexmedetomidine and dopamine in high-risk renal patients undergoing cardiac surgery: a double-blind randomized study","volume":"20","author":"Soliman","year":"2017","journal-title":"Ann Card Anaesth"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"33","DOI":"10.1016\/j.jclinane.2017.03.053","article-title":"The effect of dexmedetomidine on renal function in patients undergoing cardiac valve replacement under cardiopulmonary bypass: a double-blind randomized controlled trial","volume":"40","author":"Zhai","year":"2017","journal-title":"J Clin Anesth"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"e019008","DOI":"10.1136\/bmjopen-2017-019008","article-title":"Perioperative application of dexmedetomidine for postoperative systemic inflammatory response syndrome in patients undergoing percutaneous nephrolithotomy lithotripsy: results of a randomised controlled trial","volume":"8","author":"Deng","year":"2018","journal-title":"BMJ Open"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1080\/02656736.2018.1526416","article-title":"Effect of intraoperative dexmedetomidine on renal function after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy: a randomized, placebo-controlled trial","volume":"36","author":"Song","year":"2019","journal-title":"Int. J Hyperther"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"1553","DOI":"10.1007\/s11255-019-02171-9","article-title":"Determining whether dexmedetomidine provides a Reno-protective effect in patients receiving laparoscopic radical prostatectomy: a pilot study","volume":"51","author":"Wu","year":"2019","journal-title":"Int Urol Nephrol"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"1132","DOI":"10.1111\/pan.13995","article-title":"Effects of intraoperative dexmedetomidine on the incidence of acute kidney injury in pediatric cardiac surgery patients: a randomized controlled trial","volume":"30","author":"Kim","year":"2020","journal-title":"Paediatr Anaesth"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"386","DOI":"10.1016\/j.bja.2019.12.036","article-title":"Effect of dexmedetomidine on acute kidney injury after aortic surgery: a single-Centre, placebo-controlled, randomised controlled trial","volume":"124","author":"Soh","year":"2020","journal-title":"Br J Anaesth"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"e23998","DOI":"10.1097\/MD.0000000000023998","article-title":"Effect of dexmedetomidine on perioperative hemodynamics and organ protection in children with congenital heart disease a randomized controlled trial","volume":"100","author":"Ming","year":"2021","journal-title":"Medicine"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"687","DOI":"10.1016\/j.jss.2021.06.043","article-title":"Effects of Dexmedetomidine on patients undergoing laparoscopic surgery for colorectal Cancer","volume":"267","author":"Sun","year":"2021","journal-title":"J Surg Res"},{"key":"ref34","doi-asserted-by":"publisher","first-page":"571","DOI":"10.1111\/anae.15983","article-title":"A randomised controlled trial of dexmedetomidine for delirium in adults undergoing heart valve surgery","volume":"78","author":"Wang","year":"2023","journal-title":"Anaesthesia"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"111068","DOI":"10.1016\/j.jclinane.2023.111068","article-title":"Effect of intraoperative dexmedetomidine on long-term survival in older patients after major noncardiac surgery: 3-year follow-up of a randomized trial","volume":"86","author":"Xing","year":"2023","journal-title":"J Clin Anesth"},{"key":"ref36","doi-asserted-by":"publisher","first-page":"9","DOI":"10.3389\/fcvm.2022.938790","article-title":"Dexmedetomidine and acute kidney injury following cardiac surgery in pediatric patients-an updated systematic review and meta-analysis","volume":"9","author":"Wang","year":"2022","journal-title":"Front Cardiovasc Med"},{"key":"ref37","doi-asserted-by":"publisher","first-page":"505","DOI":"10.1097\/ALN.0b013e3181979440","article-title":"Development and validation of an acute kidney injury risk index for patients undergoing general surgery: results from a national data set","volume":"110","author":"Kheterpal","year":"2009","journal-title":"Anesthesiology"},{"key":"ref38","doi-asserted-by":"publisher","first-page":"25","DOI":"10.2147\/DHPS.S122207","article-title":"Update on the renal toxicity of iodinated contrast drugs used in clinical medicine","volume":"9","author":"Andreucci","year":"2017","journal-title":"Drug Healthcare Pat Saf"},{"key":"ref39","doi-asserted-by":"publisher","first-page":"253","DOI":"10.1007\/s11604-015-0408-3","article-title":"The incidence of contrast medium-induced nephropathy following endovascular aortic aneurysm repair: assessment of risk factors","volume":"33","author":"Guneyli","year":"2015","journal-title":"Jpn J Radiol"},{"key":"ref40","doi-asserted-by":"publisher","first-page":"201","DOI":"10.1177\/1526602815573227","article-title":"Inflammatory response and renal function following endovascular repair of the descending thoracic aorta","volume":"22","author":"Moulakakis","year":"2015","journal-title":"J Endovasc Ther Off J Int Soc Endovas Special"},{"key":"ref41","doi-asserted-by":"publisher","first-page":"R153","DOI":"10.1186\/cc10283","article-title":"Dexmedetomidine provides renoprotection against ischemia-reperfusion injury in mice","volume":"15","author":"Gu","year":"2011","journal-title":"Crit Care"},{"key":"ref42","doi-asserted-by":"publisher","DOI":"10.1093\/jpp\/rgae044","article-title":"Dexmedetomidine affects the NOX4\/Nrf2 pathway to improve renal antioxidant capacity","author":"Yang","year":"2024","journal-title":"J Pharm Pharmacol"},{"key":"ref43","doi-asserted-by":"publisher","first-page":"2337287","DOI":"10.1080\/0886022X.2024.2337287","article-title":"Mechanism of dexmedetomidine protection against cisplatin induced acute kidney injury in rats","volume":"46","author":"Zheng","year":"2024","journal-title":"Ren Fail"},{"key":"ref44","doi-asserted-by":"publisher","first-page":"128","DOI":"10.1097\/PCC.0000000000000611","article-title":"Dexmedetomidine is associated with lower incidence of acute kidney injury after congenital heart surgery","volume":"17","author":"Kwiatkowski","year":"2016","journal-title":"Pediatr Critic Care Med"},{"key":"ref45","doi-asserted-by":"publisher","first-page":"2798","DOI":"10.1097\/CM9.0000000000002408","article-title":"Perioperative dexmedetomidine administration does not reduce the risk of acute kidney injury after non-cardiac surgery: a meta-analysis","volume":"135","author":"Hu","year":"2022","journal-title":"Chin Med J"},{"key":"ref46","doi-asserted-by":"publisher","first-page":"384","DOI":"10.1016\/j.bja.2018.04.046","article-title":"Efficacy of perioperative dexmedetomidine on postoperative delirium: systematic review and meta-analysis with trial sequential analysis of randomised controlled trials","volume":"121","author":"Duan","year":"2018","journal-title":"Br J Anaesth"},{"key":"ref47","doi-asserted-by":"publisher","first-page":"1095","DOI":"10.2147\/CIA.S201323","article-title":"Prevention of postoperative delirium in elderly patients planned for elective surgery: systematic review and meta-analysis","volume":"14","author":"Janssen","year":"2019","journal-title":"Clin Interv Aging"},{"key":"ref48","doi-asserted-by":"publisher","first-page":"1342","DOI":"10.1111\/anae.15469","article-title":"The effect of peri-operative dexmedetomidine on the incidence of postoperative delirium in cardiac and non-cardiac surgical patients: a randomised, double-blind placebo-controlled trial","volume":"76","author":"van Norden","year":"2021","journal-title":"Anaesthesia"},{"key":"ref49","doi-asserted-by":"publisher","first-page":"1333","DOI":"10.1111\/1440-1681.13312","article-title":"Dexmedetomidine in the prevention of postoperative delirium in elderly patients following non-cardiac surgery: a systematic review and meta-analysis","volume":"47","author":"Shen","year":"2020","journal-title":"Clin Exp Pharmacol Physiol"}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2024.1414794\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,24]],"date-time":"2024-05-24T04:40:30Z","timestamp":1716525630000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2024.1414794\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,5,24]]},"references-count":49,"alternative-id":["10.3389\/fmed.2024.1414794"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2024.1414794","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,5,24]]},"article-number":"1414794"}}