Affiliation:
1. Department of Cardiothoracic and Vascular Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India
2. Department of Biochemistry, Postgraduate Institute of Medical Education and Research, Chandigarh, India
Abstract
Background Renal dysfunction is a well-recognized major complication after coronary artery bypass grafting. Off-pump coronary artery bypass theoretically appears to have less impact on renal function. We estimated preoperative and postoperative creatinine clearance as a marker of renal dysfunction in patients undergoing off-pump and on-pump coronary artery bypass. Methods Thirty patients undergoing coronary artery bypass were randomly allocated to undergo either on-pump ( n = 15) or off-pump surgery ( n = 15). The two groups had similar preoperative demographic characteristics. Serum creatinine and creatinine clearance were measured for 4 days postoperatively and the results were compared with preoperative levels. Results The rise in serum creatinine on postoperative day 1 was 0.28 mgċdL−1 in the on-pump group and 0.22 mgċdL−1 in the off-pump group ( p = 0.27); on postoperative day 4 it was 0.15 mgċdL−1 and 0.10 mgċdL−1, respectively, ( p = 0.28). Similarly, the fall in creatinine clearance was 17.34 mLċmin−1 in the on-pump group and 19.62 mLċmin−1 in the off-pump group on postoperative day 1 ( p = 0.42), and 10.9 and 10.94 mLċmin−1, respectively, on postoperative day 4 ( p = 0.64). Conclusion Renal function is not affected by the technique of coronary artery bypass surgery, whether with or without cardiopulmonary bypass, in spite of the theoretical advantage of off-pump surgery. Our study suggests that off-pump coronary artery bypass surgery does not confer significant protection from postoperative renal dysfunction in low-risk patients, when compared with on-pump surgery.
Subject
Cardiology and Cardiovascular Medicine,Pulmonary and Respiratory Medicine,General Medicine,Surgery
Cited by
7 articles.
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