Authors: Chun-yan Ye et al.
Source: Anaesthesia Critical Care & Pain Medicine, 2025. DOI: 10.1016/j.accpm.2025.101581
This retrospective cohort study examined whether perioperative intravenous nonsteroidal anti-inflammatory drug (NSAID) use increases the risk of acute kidney injury (AKI) following partial or radical nephrectomy. The analysis included 3,359 adult patients, of whom 78% received NSAIDs postoperatively. After propensity-score matching, 739 pairs were compared between NSAID and non-NSAID groups.
Results
There was no difference in postoperative AKI incidence between NSAID users and nonusers (27.6% vs 27.9%; HR 0.98, 95% CI 0.80–1.19; P = 0.90). AKI severity also did not differ (OR 0.99, 95% CI 0.79–1.24; P = 0.91). NSAID-related adverse effects were rare and not significantly higher in the NSAID group (OR 1.50; P = 0.53). Notably, NSAID administration was associated with a shorter median postoperative hospital stay (5 vs 6 days; P < 0.001).
Conclusions
Perioperative NSAID use in nephrectomy patients was not linked to increased AKI risk or severity, suggesting that these agents may be safe for postoperative analgesia in this population. Their use may also contribute to faster recovery and shorter hospitalization. However, the authors recommend prospective randomized trials to confirm these findings and establish definitive perioperative guidelines.
What You Should Know
• NSAIDs did not raise the risk or worsen the severity of postoperative AKI after nephrectomy.
• Hospitalization time was modestly reduced among NSAID users.
• NSAIDs appear to be a safe, opioid-sparing option for postoperative analgesia in appropriately selected renal surgery patients.
• Further interventional studies are needed to validate renal safety and guide clinical protocols.
Thank you to Anaesthesia Critical Care & Pain Medicine for publishing this important analysis on postoperative NSAID safety in nephrectomy patients.