Journal of Cardio-Thoracic Medicine

Journal of Cardio-Thoracic Medicine

A Propensity Score Analysis of Renal Dysfunction in Patients after On-Pump and Off-Pump Coronary Artery Bypass Surgery

Document Type : Original Article

Authors
Rajkamal Vishnu 1
Guruprasad Rai 1
Arvind Bishnoi 1
Ganesh Kamath Sevagur 1
Pranav Balakrishnan 1
yogesh gaude 2
Navin Patil 3
Lokvendra Budania 2
1 Department of Cardiovascular Thoracic Surgery,Kasturba Medical College, Manipal Academy of Higher Education, Manipal, India
2 Department of Anaesthesiology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, India
3 Department of Pharmacology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, India
10.22038/jctm.2019.40561.1233
Abstract
INTRODUCTION- Cardiovascular disease has emerged as a major health burden worldwide with coronary artery disease [CAD] causing highest mortality and morbidity. Coronary revascularization is the preferred treatment for patients with multivessel CAD. Based on the application of cardiopulmonary bypass [CPB], Coronary revascularization can be on-pump [OPCAB] or off-pump [CABG].The CPB is known to have multifactorial effects on all end-organ functions due to nonpulsatile flow and inflammation response. Renal function alteration is one of the multiple deleterious effects. There have been reports on superior renal function using off-pump CABG . The present study aimed to investigate and compare the prevalence of renal dysfunction in the two techniques [OPCAB versus CABG].
METHODS- This was a single-center retrospective study conducted with the data from 199 patients categorized into two groups of off-pump [n=106] and on-pump [n=93]. Renal parameters were monitored on the days 0, 1, 3, 5 after the operation using Glomerular Filtration Rate [GFR]. Creatinine clearance [CrCl] of patients with diabetes, hypertension, both diabetes and hypertension, and normal patients was also correlated.
RESULTS- Two groups of on-pump and off-pump were combined and classified according to Propensity Score. Renal functions were compared between the two groups no significant difference in renal function between the off-pump and on-pump groups.
CONCLUSION-In the present study, there were no significant differences between the two techniques in renal outcomes. Both groups shared an almost similar change of trends in renal functions.
Keywords
Acute renal failure
coronary artery disease
cardiopulmonary bypass
Glomerular Filtration Rate
Creatinine clearance
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Journal of Cardio-Thoracic Medicine
Volume 7, Issue 3
Summer 2019
Pages 474-483