Acute kidney injury: Effect of perioperative aspirin and clonidine on AKI

AKI, a common complication of surgery, is associated with poor outcomes and high health-care costs. Promising data from preclinical and clinical studies suggested that the common antiplatelet aspirin or the centrally acting α2-adrenergic agonist clonidine might reduce the risk of AKI. To investigate the effects of aspirin and clonidine on AKI, Garg and colleagues performed a substudy of the POISE-2 trial, by randomly assigning 6,905 patients undergoing noncardiac surgery across 88 centres to receive aspirin (200 mg) or placebo 2–4 h before surgery and then aspirin (100 mg) or placebo daily up to 30 days after surgery, or to receive oral clonidine (0.2 mg) or placebo 2–4 h before surgery and then a transdermal clonidine patch (0.2 mg per day) or a placebo patch that remained until 72 h after surgery. The researchers found no difference in the risk of AKI among patients receiving aspirin or clonidine versus placebo. They performed post hoc analyses to investigate whether the interventions could cause harm. ACUTE KIDNEY INJURY