Rozendaal, Jelle J H (2022) Metamizole as a possible safe NSAID in living donor nephrectomy. thesis, Medicine.
Full text available on request.Abstract
Introduction Nonsteroidal anti-inflammatory drugs (NSAIDs) have long been contraindicated in living kidney donors because of their risk of decreasing kidney function due to constriction of the afferent arteriole in the glomerulus. The NSAID metamizole is regarded to be less detrimental for kidney function with less vasoactive effects and is therefore being increasingly used perioperatively in living kidney donors. We aimed to study the association between perioperative metamizole use and post-donation measured GFR (mGFR) in living kidney donors. Methods In this cohort study, 82 kidney donors with perioperative metamizole use were matched to 73 kidney donors without perioperative metamizole use, using propensity matching. We measured mGFR pre- and 3 months post-donation using continuous 125I-iothalamate infusion and tested for differences by means of an independent t-test. Determinants of a lower post-donation mGFR were assessed using multivariable linear regression analyses. Results Donors in the metamizole group were 3 years older and donated 3 years more recently (both p<0.001). Post-donation, mGFR of donors with perioperative metamizole use was lower compared to donors without perioperative metamizole use (70 vs. 76 mL/min/1.73m2, p=0.01). Donors who used higher metamizole doses did not have a higher decrease in mGFR (<2500 mg vs. 2500-7500 mg vs. 7500 mg: -37 vs. -36 vs. -37 mL/min/1.73m2, p=0.62). In univariable linear regression analyses metamizole use was negatively associated with mGFR post-donation (st. β -0.2 [CI: -10.1;-1.2] p=0.01). However, after adjustment for potential confounders, especially the year of donation, perioperative metamizole use was not associated with post-donation mGFR (st. β -0.01 [CI: -2.9;2.3] p=0.83). Conclusion Perioperative metamizole use is not associated with a lower post-donation kidney function in living kidney donors. Metamizole may therefore be a safe perioperative pain management strategy in living kidney donors. Further research is needed to assess whether metamizole can be used as an analgesic in patients with impaired kidney function.
| Item Type: | Thesis (UNSPECIFIED) |
|---|---|
| Supervisor name: | Bakker, Prof. Dr. Stephan J L and van Londen, Dr. Marco |
| Faculty: | Medical Sciences |
| Date Deposited: | 23 Jun 2023 13:07 |
| Last Modified: | 23 Jun 2023 13:07 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/3561 |
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