The impact of off-pump coronary artery bypass surgery on postoperative renal function.

Journal article

OBJECTIVES: A number of risk factors have been recognised for postoperative renal dysfunction following on-pump coronary artery bypass surgery (CABG). There are, however, few studies that have evaluated the potential reno-protective effects of off-pump CABG in the presence of other confounding risk factors. The aim of this study was to determine if off-pump CABG reduces the risk of renal injury. METHODS: Serum creatinine values (preoperatively and day 1, 2 and 4 postoperatively) and other clinical data were prospectively collected on 1580 consecutive patients who underwent first-time CABG from 2002 to 2005. Creatinine clearance was calculated using the Cockcroft and Gault equation. The effect of on-pump vs. off-pump CABG on renal function was analysed, adjusting for age, gender, diabetes mellitus, left ventricular (LV) function and preoperative creatinine clearance, using multiple regression analysis. RESULTS: One thousand one hundred and forty-five (73%) patients underwent on-pump CABG and 435 (27%) underwent off-pump CABG. The two groups were similar with respect to age, gender and diabetes. Two hundred and seventy-four (17%) patients were females and 274 (17%) patients had diabetes. Multivariate analysis demonstrated significantly lower creatinine clearance postoperatively in patients with diabetes (P<0.001) and advanced age (P<0.001). The on-pump group had significantly lower postoperative creatinine clearance in comparison to the off-pump group (P= 0.01). The effect remained consistent after adjusting for potential risk factors (age, diabetes, gender, LV function and preoperative creatinine clearance) in the multivariate analysis. CONCLUSION: Off-pump surgery is associated with a reduction in postoperative renal injury.

Authors: Abu-Omar, Y; Taghavi, F; Navaratnarajah, M; Ali, A; Shahir, A

• Publication status: Published
• Journal: Perfusion
• Volume: 27
• Issue: 2
• Pages: 127-131
• Publication date: 2012-03-01
• DOI: 10.1177/0267659111429890
• EISSN: 1477-111X
• ISSN: 0267-6591
• Language: English
• Keywords: Postoperative Complications; Male; Aged; Humans; Coronary Artery Bypass; Middle Aged; Cardiopulmonary Bypass; Kidney; Creatinine; Coronary Artery Bypass, Off-Pump; Risk Factors; Kidney Diseases; Female; Postoperative Period