Key result
Sevoflurane increases perioperative AKI risk ~174% vs propofol.
Why the study?
Sevoflurane was suggested to lower AKI after heart surgery compared to intravenous anaesthetics, but recent studies showed opposite results.
Does sevoflurane anaesthesia increase the risk of perioperative acute kidney injury compared to propofol?
Meta-Analysis
Does sevoflurane anaesthesia increase the risk of perioperative acute kidney injury compared to propofol?
Odds Ratio: 2.74 (95% CI 1.62–4.65)
p-value: p=0.0002
In a meta-analysis of 10 RCTs, sevoflurane anaesthesia was associated with a significantly increased risk of perioperative acute kidney injury and prolonged ICU and hospital stays compared to propofol.
Sevoflurane may increase perioperative AKI risk versus propofol after cardiac surgery; challenges prior suggestions and warrants caution pending confirmatory RCTs.
Sevoflurane has been suggested to lower the incidence of acute kidney injury (AKI) after heart surgery compared to intravenous anaesthetics. However, recent studies indicated opposite results. Therefore, this meta-analysis was conducted on randomised controlled trials (RCTs) to determine if sevoflurane decreases the risk of AKI compared to propofol. Relevant RCTs were identified from PubMed, EMBASE databases, and reference lists of reviews and related articles till June 6, 2023. Review Manager was used for statistical analysis. In this study, 10 RCTs were included. Compared with propofol, sevoflurane increased the incidence of AKI (odds ratio [OR], 2.74; 95% confidence interval [CI], 1.62-4.65; p = 0.0002; I2 = 13%) and prolonged the length of intensive care unit (standard mean difference [SMD], 0.29; 95% CI, 0.06-0.53; p = 0.01; I2 = 0%) and hospital stays (mean difference [MD], 1.62; 95% CI, 0.59-2.64; p = 0.002; I2 = 0%). Based on current evidence, sevoflurane was linked to an increased risk of perioperative AKI compared to propofol. To verify the results, more high-quality RCTs are necessary.
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Li et al. (2025) conducted a meta-analysis in Perioperative acute kidney injury. Sevoflurane vs. Propofol was evaluated on Incidence of acute kidney injury (AKI) (OR 2.74, 95% CI 1.62-4.65, p=0.0002). Compared with propofol, sevoflurane anaesthesia significantly increased the incidence of perioperative acute kidney injury (OR 2.74; 95% CI 1.62-4.65; p=0.0002).
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