Effect of ketorolac on renal function after donor nephrectomy

Area of Science:

• Nephrology
• Pharmacology
• Surgical Anesthesiology

Background:

• Nonsteroidal anti-inflammatory drugs (NSAIDs) like ketorolac are increasingly used for postoperative pain management.
• Donor nephrectomy patients are typically healthy, making them a suitable group to assess drug safety.
• Understanding ketorolac's renal effects in this population is crucial for optimizing perioperative care.

Purpose of the Study:

• To evaluate the safety and renal effects of ketorolac in healthy patients undergoing open donor nephrectomy.
• To determine if ketorolac use is associated with short-term or long-term renal function impairment.
• To identify any potential interactions between ketorolac and patient-specific factors affecting renal outcomes.

Main Methods:

• Retrospective review of 198 open living donor nephrectomy patients (1998-2000).
• Comparison of renal function (creatinine clearance) between patients who received ketorolac and those who did not.
• Regression analysis to assess interactions between ketorolac and donor age, sex, weight, blood loss, and operative time.

Main Results:

• No significant preoperative differences in renal function between groups.
• A slight, transient decrease in creatinine clearance on postoperative day 2 in the ketorolac group (P=0.05).
• No significant difference in renal function at 3 months postoperatively (P=0.92); no dose-dependent effects or interactions with clinical variables were observed.

Conclusions:

• Ketorolac use for the first two postoperative days in healthy donor nephrectomy patients is not linked to lasting renal impairment.
• No specific patient subset or maximum ketorolac dose was identified as unsafe within the administered range.
• Short-term ketorolac administration appears safe for renal function in this specific surgical context.