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Abstract: FR-PO098

The Use of Anti-Adrenergic Agents as a Predictor of AKI and Delayed Recovery of Kidney Function: The NARA-AKI Cohort Study

Session Information

Category: Acute Kidney Injury

  • 101 AKI: Epidemiology, Risk Factors, and Prevention


  • Nishimoto, Masatoshi, Nara Kenritsu Ika Daigaku Fuzoku Byoin, Kashiwara, Nara, Japan
  • Murashima, Miho, Nagoya Shiritsu Daigaku, Nagoya, Aichi, Japan
  • Kokubu, Maiko, Nara-ken Sogo Iryo Center, Nara, Nara, Japan
  • Matsui, Masaru, Nara-ken Sogo Iryo Center, Nara, Nara, Japan
  • Eriguchi, Masahiro, Nara Kenritsu Ika Daigaku Fuzoku Byoin, Kashiwara, Nara, Japan
  • Samejima, Ken-ichi, Nara Kenritsu Ika Daigaku Fuzoku Byoin, Kashiwara, Nara, Japan
  • Akai, Yasuhiro, Nara Kenritsu Ika Daigaku Fuzoku Byoin, Kashiwara, Nara, Japan
  • Tsuruya, Kazuhiko, Nara Kenritsu Ika Daigaku Fuzoku Byoin, Kashiwara, Nara, Japan

Association of anti-adrenergic agents with postoperative acute kidney injury (AKI) and with trajectory of kidney function after AKI is still unknown.


In a retrospective cohort study, adults undergoing non-cardiac surgery under general anesthesia were included. Obstetric or urological surgery, missing data, or preoperative dialysis was excluded. The exposure of interest was preoperative regular use of anti-adrenergic agents. The outcomes were AKI within 1 week postoperatively and trajectories of kidney function within 2 weeks postoperatively among patients with AKI. Multivariable logistic regression models were used to examine the association of anti-adrenergic agents with AKI. Linear mixed-effects models were used to compare the trajectories of postoperative kidney function after AKI between patients with and without anti-adrenergic agents.


Among 5168 patients, 245 had used anti-adrenergic agents. A total of 309 (6.0%) developed AKI, and the use of anti-adrenergic agents was independently associated with postoperative AKI even after adjustment for preoperative and intraoperative potential confounders [OR (95% CI): 1.76 (1.14–2.71)]. As a sensitivity analysis, propensity score matched analysis yielded the similar result [OR (95% CI): 1.78 (1.003–3.15)]. The association was similar across preexisting hypertension or cardiovascular disease. Analyses restricted to patients with AKI suggested that the timing and stage of AKI were similar among those with and without anti-adrenergic agents; however, the recovery of kidney function was delayed among those with anti-adrenergic agents (P for interaction = 0.004).


The use of anti-adrenergic agents was associated with postoperative AKI, and delayed recovery of kidney function after AKI. Temporary withdrawal of anti-adrenergic agents during perioperative periods may contribute to prevent AKI and shorten the duration of AKI.