Stueber T, et al. - This study investigated the perioperative nephrotoxic potential of dipyrone in patients prone to acute kidney injury (AKI). In adult ICU patients, use of dipyrone in increasing dosage was a potential independent risk factor for AKI and might prolong vasopressor therapy. Also, clinical evidence for a benefit of dipyrone therapy in the ICU was insufficient.

Methods

• A retrospective cohort study was performed in a tertiary referral hospital from January 2013 until June 2013 in a total of 500 consecutive patients aged 18 years and older referred to the anaesthesia ICU.
• Patients were excluded if admitted from or discharged to other ICUs, if referred for post resuscitation care, or if repeatedly admitted to the ICU.
•  Incidence of AKI, as defined by the Kidney Disease: Improving Global Outcomes Acute Kidney Injury Work Group criteria, and duration of vasopressor therapy.

Results

• Findings demonstrated that use of dipyrone was associated with an increased incidence of AKI in a dose-dependent manner with a 1.6-fold increase in the incidence of AKI with each additional gram of intravenous dipyrone per day.
• Researchers observed that dipyrone dose of more than 2.5 g day^-1 was the best risk predictive cut-off for AKI.
• Data also revealed that patients receiving dipyrone on the ICU presented with a prolonged duration of vasopressor therapy.