Effect of Nicardipine on Renal Function After Robot-assisted Laparoscopic Radical Prostatectomy

Jang Eun Cho, Jae Kwang Shim, Jae Hyun Chang, Young Jun Oh, Hae Keum Kil, Koon Ho Rha, Young Lan Kwak

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Objectives: To investigate the renoprotective effect of nicardipine in patients undergoing robot-assisted laparoscopic radical prostatectomy (RALRP) in a prospective trial. Superior visualization of the increasingly performed RALRP requires pneumoperitoneum and extreme head-down tilt, both of which are associated with a decrease in postoperative renal function. Nicardipine causes preferential dilation of the renal arterioles and attenuates renal dysfunction after cardiac surgery. Methods: After we obtained institutional review board approval, we randomly treated 100 patients undergoing RALRP with a continuous infusion of nicardipine at a rate of 0.5 μg/kg/min (nicardipine group, n = 50) or with normal saline (control group, n = 50) during surgery. We measured the serum creatinine (Cr) level and estimated glomerular filtration rate (eGFR) 1 day before surgery and the first and third postoperative days (POD 1 and 3, respectively). Results: Patients' characteristics and operative data were similar between groups. The serum Cr was significantly higher and the eGFR was significantly lower in the control group at POD 1. The number of patients having renal insufficiency (eGFR < 60 mL/min/1.73 m2) and abnormal serum creatinine level (>1.4 mg/dL) was significantly greater in the control group (9 vs 1, and 4 vs none, respectively) at POD 1. Conclusions: Continuous infusion of low-dose nicardipine during RALRP seems to offset the deleterious effects of inevitable pneumoperitoneum and extreme head-down tilt on renal function in preserving the eGFR and attenuating the development of renal insufficiency in the immediate postoperative period.

Original languageEnglish
Pages (from-to)1056-1060
Number of pages5
JournalUrology
Volume73
Issue number5
DOIs
Publication statusPublished - 2009 May 1

All Science Journal Classification (ASJC) codes

  • Urology

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