Abstract
Abstract
Objectives
Furosemide is usually administered before the Coronary artery bypass grafting (CABG) to improve water–sodium retention. However, no final conclusions are available on the postoperative renal outcome of furosemide. We evaluated the effect of preoperative furosemide on acute kidney injury (AKI) after CABG.
Methods
We recorded the use of furosemide 14 days before surgery in all patients who underwent CABG from 2016 to 2017. Patients were divided into furosemide (F) group and non-furosemide (NF) group according to preoperative use of furosemide. A 1:1 propensity score matching was performed. Multivariate analyses were conducted to determine risk factors for AKI after CABG.
Results
Overall, 974 patients were included in the study, of which 82 cases were complicated with postoperative AKI. The incidence of AKI was significantly increased in F group than NF group (28.9% vs. 7.4%, p = 0.000). After adjusting for risk factors, the incidence of AKI in the F group was 5.34 times more than the NF group (95% confidence interval [CI] 2.45–11.64; p = 0.000). The incidence of AKI increased significantly when the cumulative dosage of furosemide exceeded 110 mg (odds ratio [OR] 6.23; 95% CI 2.07–18.74, p = 0.001) and 250 mg (OR 8.31; 95% CI 2.87–24.02, p = 0.000). After the propensity-matching group analysis, same results were obtained.
Conclusions
The incidence of AKI after CABG was related to the use of preoperative furosemide, and it increased exponentially with the increase of cumulative dose of furosemide. This provides guidance for the dose of preoperative furosemide.
Funder
the National Key R&D Program of China
National Natural Science Foundation of China
Publisher
Springer Science and Business Media LLC
Subject
Cardiology and Cardiovascular Medicine,Pulmonary and Respiratory Medicine,General Medicine,Surgery
Reference25 articles.
1. Shengshou Hu,Runlin Gao,Lisheng Liu,Manlu Zhu,Wen wang,Yongjun Wang,et al. Summary of China cardiovascular disease report 2018. China circulation magazine, 2019,34(3): 209–220. 2.Garg AX,Devereaux PJ,Yusuf S, Cuerden MS,Parikh CR,Coca SG,et al.Kidney function after off‑pump or on‑pump coronary artery bypass graft surgery: A randomized clinical trial.JAMA,2014,311:2191‑2198.
2. Olsson D, Sartipy U, Braunschweig F, Holzmann MJ. Acute kidney injury following coronary artery bypass surgery and long-term risk of heart failure. Circ Heart Fail. 2013;6:83–90.
3. Takaki S, Shehabi Y, Pickering JW, Endre Z, Miyashita T, Goto T, et al. Perioperative change in creatinine following cardiac surgery with cardiopulmonary bypass is useful in predicting acute kidney injury: a single-centre retrospective cohort study. Interact Cardiovasc Thorac Surg. 2015;21(4):465–9.
4. Ortega-Loubon C, Fernández-Molina M, Pañeda-Delgado L, Jorge-Monjas P, Carrascal Y, et al. Predictors of Postoperative Acute Kidney Injury after Coronary Artery Bypass Graft Surgery. Braz J Cardiovasc Surg. 2018;33(4):323–9.
5. Li Z,Fan G, Zheng X, Gong X, Chen T, Liu X,et al. Risk factors and clinical significance of acute kidney injury after on-pump or off-pump coronary artery bypass grafting: a propensity score-matched study.Interact Cardiovasc Thorac Surg.2019;28(6):893–899.
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