An interventional study of Dexmedetomidine and Remifentanil in Acute Kidney Injury, Crush Injury and Rhabdomyolysis, sponsored by Ankara City Hospital Bilkent. Completed at 1 site in Turkey (Türkiye). Per ClinicalTrials.gov, last updated 2025-07-30.
Sponsored by Ankara City Hospital Bilkent · Not applicable, Interventional, and Basic science
The goal of this interventional preclinical study is to evaluate the potential protective effects of two intravenous anesthetic agents-dexmedetomidine and remifentanil-on kidney function in the context of muscle crush injury, which is known to be a major contributor to acute kidney injury (AKI) following trauma, entrapment, or disasters such as earthquakes. AKI following crush syndrome results from rhabdomyolysis, hypovolemia, oxidative stress, and systemic inflammation, and it significantly increases morbidity and mortality. This study explores whether anesthetic choice during the acute phase of injury influences renal outcomes.
This study used a rat model of crush injury. A total of 28 healthy adult male Wistar rats were randomly divided into four groups (n=7 per group):
Crush injury was induced by applying a metal clamp with a constant pressure of 3 kg to both gastrocnemius muscles for 2 hours, under anesthesia. After the clamp was removed, animals in the two treatment groups received a one-hour intravenous infusion of their assigned drug. Blood samples were taken at baseline and at 6 hours post-injury. After euthanasia, bilateral kidney tissues were harvested for biochemical and histopathological evaluation.
The main questions this study aimed to answer were:
Biochemical analyses included ELISA-based quantification of NGAL, KIM-1, TIMP-2, IGFBP7, TAC, TOS, serum creatinine, and BUN. Histopathological scoring was performed by a blinded pathologist, assessing tubular necrosis, interstitial edema, and inflammatory cell infiltration.
The study found that rats in the dexmedetomidine group exhibited lower levels of renal injury markers and histopathological damage scores compared to those in the remifentanil group. These findings suggest that dexmedetomidine may offer superior renal protection during acute crush injury compared to remifentanil, potentially via anti-inflammatory and antioxidant mechanisms.
The results of this study may help guide anesthetic drug selection in trauma patients at high risk of kidney injury, and lay the foundation for future translational research.
1,595 studies on the registry are indexed under Acute Kidney Injury; 371 are open to participants now.
This study's enrollment of 28 is below the median of 100 across 763 interventional studies indexed under Acute Kidney Injury.
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Rat Experiment
The control group did not receive any intervention or pharmacological treatment.
Following 2 hours of bilateral muscle compression, rats in the dexmedetomidine group underwent a 1-hour period including both laparotomy and continuous intravenous dexmedetomidine infusion.
Drug: Dexmedetomidine · Procedure: Laparotomy · Procedure: Compression
Following 2 hours of bilateral muscle compression, rats in the remifentanil group underwent a 1-hour period including both laparotomy and continuous intravenous remifentanil infusion.
Drug: Remifentanil · Procedure: Laparotomy · Procedure: Compression
In the sham group, bilateral gastrocnemius muscle compression was applied for 2 hours and laparotomy was performed, but no pharmacological intervention was given.
Procedure: Laparotomy · Procedure: Compression
Following 2 hours of bilateral muscle compression, rats in the dexmedetomidine group underwent a 1-hour period including both laparotomy and continuous intravenous dexmedetomidine infusion.
Following 2 hours of bilateral muscle compression, rats in the remifentanil group underwent a 1-hour period including both laparotomy and continuous intravenous remifentanil infusion.
A standardized laparotomy was carried out for 1 hour, during which the abdominal cavity was opened and subsequently closed. This procedure aimed to mimic the physiological impact of a one-hour surgical operation.
Bilateral compression was applied to the gastrocnemius muscles for a duration of 2 hours.
Serum Creatinine Level
Change in serum creatinine levels measured at 0, 2, and 6 hours after experimental crush injury in Wistar Albino rats receiving either dexmedetomidine or remifentanil. This outcome is used to assess renal function and the nephroprotective effect of the interventions.
Time frame: Baseline (0 hour), 2 hours, and 6 hours after intervention
Neutrophil Gelatinase-Associated Lipocalin (NGAL) Level
NGAL levels measured in serum at three time points to assess early renal tubular injury following experimental crush injury and treatment with dexmedetomidine or remifentanil. NGAL is an early biomarker for acute kidney injury (AKI) and reflects renal stress.
Time frame: 0, 2, and 6 hours after intervention
Histopathological Tubular Injury Score
Histopathological evaluation of renal tissue samples using scoring for tubular necrosis, brush border loss, dilatation, congestion, and apoptotic cell count. Quantitative damage scoring was performed blindly by two pathologists to compare the nephroprotective effects of dexmedetomidine and remifentanil.
Time frame: At 6 hours after intervention (after sacrifice)
Kidney Injury Molecule-1 (KIM-1) Level
Serum levels of KIM-1 measured by ELISA to evaluate renal tubular epithelial injury and compare the protective effects of the two anesthetic agents.
Time frame: 0, 2, and 6 hours after intervention
TIMP-2) × (IGFBP7) Product Level
0, 2, and 6 hours after intervention
Time frame: The combined serum levels of TIMP-2 and IGFBP7, representing G1 cell cycle arrest, were measured to detect early renal stress and predict AKI development in the experimental model.
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Plan to share: No — This is a preclinical animal study conducted on Wistar Albino rats. Since no human subjects were enrolled, there is no individual participant data (IPD) to share.
This study is completed, as verified in Jul 2025. You cannot join it, but the record below documents what was studied.
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Ankara City Hospital Bilkent