Related Experiment Video
Updated: Jun 27, 2026
08:35
Improved Renal Denervation Mitigated Hypertension Induced by Angiotensin II Infusion
Published on: May 26, 2022
Effect of diltiazem on kidney function during laparoscopic surgery
Ji Young Kim1, Kyung Cheon Lee, Hong Soon Kim
1Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, Korea.
Surgical Endoscopy
|December 11, 2008
Summary
Diltiazem infusion prevented a decrease in creatinine clearance during laparoscopic surgery's positive pneumoperitoneum. This kidney function protection occurred without adverse hemodynamic changes, suggesting diltiazem's potential role in preventing acute kidney injury.
Area of Science:
- Nephrology
- Anesthesiology
- Surgical Research
Background:
- Positive pneumoperitoneum during laparoscopic surgery is linked to temporary kidney function impairment.
- Investigating interventions to mitigate acute kidney injury (AKI) during these procedures is crucial.
Purpose of the Study:
- To evaluate the effect of continuous diltiazem infusion on acute kidney injury during positive pneumoperitoneum.
- To assess diltiazem's impact on renal function markers and hemodynamic stability in patients undergoing laparoscopic surgery.
Main Methods:
- Thirty-two patients (ASA 1-2) undergoing laparoscopic surgery were randomized into control (saline) and diltiazem groups.
- Diltiazem was administered at 2 microg/kg/min. Urinary flow, sodium excretion, and creatinine clearance (CrCl) were measured.
- CrCl was calculated using the Cockcroft-Gault equation pre-surgery and on postoperative days 1 and 2.
Main Results:
- Hemodynamic parameters remained similar between groups.
- Creatinine clearance (CrCl) during pneumoperitoneum was significantly higher in the diltiazem group (90.8 ml/min/1.73 m²) versus the control group (54.2 ml/min/1.73 m²).
- Postoperative urinary flow increased in both groups; CrCl at baseline and postoperatively was comparable.
Conclusions:
- Continuous diltiazem infusion at 2 microg/kg/min effectively prevented the decrease in CrCl during pneumoperitoneum without causing hemodynamic instability.
- Diltiazem shows potential for preventing further kidney injury in patients undergoing laparoscopic surgery, particularly those with pre-existing renal concerns.
Related Concept Videos
01:28Cardiac Catheterization I: Pre-Procedure Overview
Cardiac catheterization is an invasive diagnostic technique used to identify and evaluate structural and functional diseases of the heart and major blood vessels. This technique diagnoses congenital heart disease, coronary artery disease, valvular heart disease, and coronary spasms and assesses ventricular function. It helps guide treatment decisions, including the need for revascularization procedures like percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) and...
01:26Kidney Transplant II: Surgical Procedure
Preoperative ManagementThe primary goals of preoperative management in kidney transplantation are to optimize the patient’s metabolic state and prepare them for surgery through diet adjustments, necessary dialysis, and tailored medical treatment. This phase also involves comprehensive infection screening and patient education about the surgical procedure and postoperative care to improve outcomes and adherence.Medical ManagementA comprehensive evaluation is required for both the living donor...
01:20Antiarrhythmic Drugs: Class IV Agents as Calcium Channel Blockers
Class IV antiarrhythmic drugs, such as verapamil and diltiazem, block calcium channels. They primarily affect the heart, slowing the conduction in calcium-dependent tissues like the SA and AV nodes. These drugs manage reentrant supraventricular tachycardia (SVT) and reduce ventricular rate in atrial flutter/fibrillation.
Verapamil, a calcium channel blocker, inhibits calcium movement across myocardial cell membranes and vascular smooth muscle. This results in the dilation of coronary and...
Verapamil, a calcium channel blocker, inhibits calcium movement across myocardial cell membranes and vascular smooth muscle. This results in the dilation of coronary and...
01:25Drug Dosing in Renal Diseases: Dose Adjustments Based on Drug Clearance and Elimination Rate Constant
In patients with renal disease, dosage adjustments are necessary to maintain therapeutic plasma drug concentrations and prevent toxicity or subtherapeutic exposure. Renal impairment alters drug pharmacokinetics, especially in conditions like uremia, where changes such as prolonged elimination half-life and altered apparent volume of distribution can significantly affect drug disposition. These changes require careful modification of the dosing regimen to achieve the desired clinical...
01:22Heart Failure Drugs: Diuretics
Heart failure and kidney perfusion are interconnected in a complex way. Reduced renal perfusion and venous congestion are two significant factors that contribute to renal dysfunction in heart failure. The kidneys, primarily responsible for fluid balance in the body, are adversely affected due to compromised cardiac output and increased venous pressure. In response to reduced renal perfusion, the kidneys activate neurohumoral mechanisms to restore balance. However, these mechanisms can be...
01:30Acute Kidney Injury IV: Diagnostic Studies and Prevention
Accurate diagnosis and effective prevention are critical in managing Acute Kidney Injury (AKI), which is linked to high mortality rates ranging from 10% to 80%. Timely recognition of at-risk patients and careful monitoring can significantly reduce the likelihood of kidney damage.Diagnostic Assessments:The diagnostic process starts with a comprehensive medical history to identify prerenal, intrarenal, and postrenal causes.Prerenal causes, such as dehydration, hypotension, or blood loss, should...