Dose-response association between intraoperative norepinephrine and postoperative acute kidney injury: a retrospective cohort study

The authors aimed to investigate the dose-response relationship between intraoperative norepinephrine administration and the incidence of postoperative acute kidney injury (AKI), while also examining the interaction with intraoperative hypotension. Their analysis of 27,874 surgical cases revealed that higher doses of norepinephrine were significantly associated with increased AKI risk, identifying two critical dose thresholds for monitoring. The findings suggest that norepinephrine exposure is independently linked to AKI, with distinct nonlinear and linear behaviors in dose metrics, largely unaffected by hypotension.