Authors: Ye CY, et al.
Anaesthesia Critical Care & Pain Medicine. 2025; doi:10.1016/j.accpm.2025.101581
This retrospective cohort study examined whether intravenous NSAIDs increase acute kidney injury (AKI) risk after nephrectomy. The analysis included 3,359 adults undergoing partial or radical nephrectomy, of whom 78% received NSAIDs. Propensity-score matching yielded 739 patient pairs for comparison.
The incidence of AKI was nearly identical between NSAID and non-NSAID groups (27.6% vs 27.9%), with no difference in severity. NSAID-related adverse effects were rare and not significant. Importantly, NSAID use was associated with a shorter hospital stay (median 5 vs 6 days). Opioid use and hemoglobin levels were similar.
What You Should Know:
Perioperative NSAIDs did not increase the risk or severity of AKI after nephrectomy and may reduce length of hospitalization. Safe to use in high-risk patients.
Clinical Relevance:
For anesthesiologists and surgical teams, these findings support cautious but routine inclusion of NSAIDs in multimodal analgesia for nephrectomy patients. NSAIDs can provide effective opioid-sparing pain relief without compromising renal outcomes, offering reassurance in a population traditionally considered at high risk.
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