Effect of Intraoperative Nephrotoxic Drugs on Renal Function in Elderly Patients Undergoing Abdominal Surgery
SHEN Jiang-hua1, ZHAO Si-miao2, CHU Yan-qi1, YAN Su-ying1*
1. Department of Pharmacy, Xuanwu Hospital Capital Medical University, Beijing Institute of Geriatrics, National Clinical Research Center for Geriatric Disorders, Beijing 100069, China; 2. School of Pharmaceutical Sciences, Capital Medical University, Beijing 100053, China
Abstract：OBJECTIVE To analyze the relationship between renal function impairment and intraoperative nephrotoxic drugs in elderly patients undergoing abdominal surgery. METHODS A retrospective analysis was performed on renal function data before and after surgery for elderly patients (≥75 years old) who underwent abdominal surgery from January 2016 to December 2017 in Xuanwu Hospital of Capital Medical University. The medication group were divided into five groups according to the type of nephrotoxic drugs used in the operation: group (H)--hetastarch (HES), group (N)-- non-steroidal anti-inflammatory drugs (NSAIDs), group (N+H)--combined use NSAIDs and HES, group (F+H)--combined use furosemide and HES, group (Z)- iodinated contrast agent. The control group did not use nephrotoxic drugs.According to the principle of pairing, patients in the untreated group and the medication group were paired, and paired t-test was used to analyze the relationship between intraoperative nephrotoxic drugs and creatinine clearance(Ccr) reduction rates after surgery. RESULTS A total of 275 elderly patients were enrolled in the study and pairing the untreated group with the patient in the medication group, the pairing success: the number of the group (Z) is 3,and the pairing is not performed, the group (H) number is 41, the group (N) number is 15, the group (N+ H) is 21, the group (F+H) is 7. The paired t-test was used to compare the reduction rate of creatinine clearance between the two groups. The RESULTS showed that there was no significant difference in the group (H), and the other three groups′ RESULTS were all significant differences. CONCLUSION The nephrotoxic drugs such as NSAIDs, iodinated contrast agents should be controlled during the operation. In particular, the combination of multiple nephrotoxic drugs should be avoided, such as NSAIDs combined with HES and furosemide combined with HES.
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2019, Vol. 54 
