Does the use of non-steroidal anti-inflammatory drugs after cardiac surgery increase the risk of renal failure?

Interactive Cardiovascular and Thoracic Surgery
Metesh Acharya, Joel Dunning

Abstract

A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was whether the use of non-steroidal anti-inflammatory drugs (NSAIDs) for pain relief post-cardiac surgery increases the risk of renal failure. Altogether 53 papers were found using the reported search, of which 11 represented the best evidence to answer the clinical question. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated. We identified 11 studies, comprising one meta-analysis, seven randomised controlled trials (RCTs), and three retrospective studies. The meta-analysis of 1065 patients across 20 RCTs established that the risk of renal failure was not significantly higher with perioperative NSAID usage [odds ratio (OR) 0.95, 95% confidence interval (CI) 0.37-2.46]. Furthermore, there was no statistically significant difference in serum creatinine levels between NSAID and control groups. Six RCTs agreed that postoperative NSAID therapy was not associated with an elevation in serum creatinine levels suggestive of renal failure. One of these RCTs was conducted in a paediatric population undergoing congenital heart surg...Continue Reading

Citations

Mar 22, 2014·Journal of Cardiothoracic Surgery·Sulman RafiqPeter Skov Olsen
Jun 18, 2014·American Journal of Cardiovascular Drugs : Drugs, Devices, and Other Interventions·Kari Hanne GjeiloPål Klepstad
Dec 25, 2015·Journal of Cardiovascular and Thoracic Research·Saddiq Mohammad QaziMartin Agge Nørgaard
Apr 18, 2014·Pain Practice : the Official Journal of World Institute of Pain·Nalini VadiveluJoseph V Pergolizzi
Mar 7, 2015·La Presse médicale·Hélène Beloeil
Oct 16, 2013·Journal of Cardiothoracic and Vascular Anesthesia·Neal Stuart GersteinPeter Mark Schulman
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Oct 14, 2017·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Miguel Sousa-UvaUlf Landmesser
Sep 12, 2018·International Anesthesiology Clinics·Eric J P ChanowskiDaryl A Oakes
Feb 28, 2016·Journal of Intellectual Disabilities : JOID·Andrew PowerEdward Hall
Sep 28, 2020·The Annals of Thoracic Surgery·Erin M CorsiniWayne L Hofstetter
Oct 19, 2020·Journal of Cardiothoracic and Vascular Anesthesia·Jason OchrochJesse Raiten
Jul 18, 2021·Pain and Therapy·Filomena PuntilloGiustino Varrassi

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