Correlation between perioperative parecoxib and postoperative acute kidney injury in patients undergoing non-cardiac surgery: a retrospective cohort analysis

Background: The association of nonsteroidal anti-inflammatory drugs with postoperative acute kidney injury is controversial. However, there are few studies focusing on the association between parecoxib and postoperative acute kidney injury. Methods: We retrospectively reviewed the electronic medical records and laboratory results of 9,246 adult patients (18–60 years) undergoing non-cardiac surgery at Third Xiangya Hospital of Central South University from January 1, 2012 to August 31, 2017. Study groups were either treated with or without parecoxib. Univariable analysis identified demographic, preoperative laboratory, and intraoperative factors associated with acute kidney injury. Logistic stepwise regression was used to calculate the adjusted odds ratio of parecoxib and acute kidney injury association. Results: The incidence of postoperative acute kidney injury was 6.06% and parecoxib was used in 0.105% of patients. The mortality was 4.64% in the acute kidney injury group. The incidence of acute kidney injury was lower in the parecoxib-administered group (4%) than in the without parecoxib-administered group (6.3%, p = 0.005). Postoperative acute kidney injury risk reduced by 33.40% in the parecoxib-administered group after adjusting for interference factors. Conclusions: Intraoperative single-dose parecoxib (40 mg or 80 mg) might reduce postoperative acute kidney injury risk in adult patients undergoing non-cardiac surgery.