From the Research
For patients with reduced kidney function, atracurium is the preferred muscle relaxant due to its minimal impact on renal function, as evidenced by a study published in 2024 1. When considering muscle relaxants for patients with reduced kidney function, it is crucial to prioritize those that are least affected by impaired renal function to minimize the risk of toxicity and adverse effects.
- Atracurium is one such agent that has been found to be minimally affected by renal impairment, making it a safer choice for patients with reduced kidney function 1.
- Other muscle relaxants like cisatracurium and rocuronium may require dose adjustments in patients with renal failure due to altered clearance 1.
- The use of reversal agents like neostigmine and sugammadex should also be carefully considered, as they can affect renal markers, with sugammadex potentially having a milder impact on glomerular function compared to neostigmine 1.
- It is essential to start with the lowest possible dose, extend dosing intervals, monitor for side effects, and regularly assess kidney function when prescribing muscle relaxants to patients with kidney dysfunction.
- Non-pharmacological approaches like physical therapy should also be considered as first-line or adjunctive treatment.
- The selection of a muscle relaxant should be based on the most recent and highest quality evidence, which in this case suggests atracurium as a preferred option for patients with reduced kidney function 1.