BACKGROUND Flurbiprofen axetil (FA) is a commonly prescribed agent to relieve perioperative pain, but the relationship between FA and postoperative acute kidney injury (AKI) remains unclear. This study attempted to evaluate the effects of different dose of perioperative FA on postoperative AKI. METHODS A total of 9915 patients were enrolled for this retrospective study. The clinical characteristics and the prevalence of postoperative AKI among patients non-using, using low dose (50-100 mg), middle dose (100-250 mg) and large dose (≧250 mg) of FA were analyzed respectively. The impact of different dose of FA on postoperative AKI was analyzed using univariable and multivariate logistic regression analysis. RESULTS The prevalence of postoperative AKI was 6.7% in the overall subjects and 5.1% in 2446 cases who used FA. The incidence of AKI in low dose group was significantly less than that of non use group (4.5% vs 7.2%, P < 0.001), but the incidence of AKI in large dose group was significantly higher than that in the non-use group (18.8% vs 7.2%, P < 0.001). However, there was no significant difference between patients without using FA and subjects using middle dose of FA (7.2% vs 5.6%, p = 0.355). Multivariate logistic regression analysis showed that low dose of FA was a protective factor for postoperative AKI (OR = 0.75, p = 0.0188), and large dose of FA was a risk factor for postoperative AKI (OR = 4.8, p < 0.0001). CONCLUSIONS The impact of FA on postoperative AKI was dose-dependent, using of low dose FA (50-100 mg) perioperatively may effectively reduce the incidence of postoperative AKI.

中文翻译：

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低剂量氟比洛芬酯降低术后急性肾损伤的发生率：9915例临床资料回顾性分析。

背景技术氟比洛芬酯（FA）是缓解围手术期疼痛的常用处方药，但FA与术后急性肾损伤（AKI）之间的关系仍不清楚。本研究试图评估围手术期不同剂量FA对术后AKI的影响。方法回顾性研究共纳入9915例患者。分别分析了低剂量（50-100 mg），中剂量（100-250 mg）和大剂量（≥250mg）FA不使用的患者的临床特征和术后AKI患病率。使用单变量和多元logistic回归分析分析了不同剂量的FA对术后AKI的影响。结果总体受试者的术后AKI患病率为6.7％，使用FA的2446例患病率为5.1％。低剂量组的AKI发生率明显低于不使用组（4.5％vs 7.2％，P <0.001），但是大剂量组的AKI发生率明显高于不使用组（ 18.8％和7.2％，P <0.001）。然而，不使用FA的患者与使用中等剂量FA的受试者之间没有显着差异（7.2％vs 5.6％，p = 0.355）。多因素logistic回归分析表明，低剂量的FA是术后AKI的保护因素（OR = 0.75，p = 0.0188），大剂量的FA是术后AKI的危险因素（OR = 4.8，p <0.0001）。结论FA对术后AKI的影响是剂量依赖性的，围手术期使用低剂量FA（50-100 mg）可有效降低术后AKI的发生率。