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Kidney Week

Abstract: FR-PO034

Use of Tramadol and Reduced Risk of AKI in Hospitalized Children

Session Information

Category: Acute Kidney Injury

  • 101 AKI: Epidemiology, Risk Factors, and Prevention


  • Pi, Mingjing, Nanfang Hospital, Southern Medical University, Guang Zhou, Guang Zhou, China
  • Xu, Xin, Renal Division, Nanfang Hospital, Southern Medical University; National Clinical Research Center for Kidney Disease, Guangzhou, China

Various interventions have been reported to prevent the development of AKI, but only few have been validated in children. This study is aimed to investigate the potential renoprotective effect of tramadol on the risk of pediatric AKI.


We conducted a multicenter retrospective cohort study in hospitalized children aged 1 month to 18 years from 25 tertiary hospitals across China during 2013-2015. Patient-level data were obtained from the electronic hospitalization information system. The outcome was hospital-acquired (HA-)AKI. AKI was defined and staged by Kidney Disease Improving Global Outcomes criteria. Patients who developed AKI after two days of admission were identified as having HA-AKI. We used a cox proportional hazards model to estimate the risk of HA-AKI, in which exposure to tramadol was modeled as a time-varying variable.


Among 46295 children analyzed, 1779 (3.8%) used tramadol and 3555 (7.68%) had HA-AKI events during hospitalization. Most of tramadol (53.18%) was prescribed for postoperative analgesia. After adjusting for demographics status, prevalent comorbidities and concomitant use of medications, use of tramadol was associated with a significantly reduced risk of HA-AKI compared with non-users (HR 0.20; 95% CI, 0.15-0.27). The results were consistent in subgroups and multiple sensitivity analysis. An increasing cumulative dosage of tramadol use was associated with a graded lower risk of HA-AKI.


Tramadol was associated with a reduced risk of HA-AKI in hospitalized children. Future intervention study should evaluate whether tramadol use could prevent AKI in high risk patients.


  • Government Support - Non-U.S.