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Effect of off-pump and on-pump coronary artery bypass grafting on renal function
Jale Bengi Celik1, Niyazi Gormus, Ahmet Topal
1Department of Anesthesiology, Meram Medical School of Selcuk University, Konya, Turkey. jalecelik@hotmail.com
Insights
Off-pump coronary artery bypass grafting (CABG) better preserves renal function compared to on-pump surgery. This technique shows improved creatinine clearance and faster recovery of kidney function post-CABG.
Area of Science:
- Cardiovascular Surgery
- Nephrology
- Anesthesiology
Background:
- Coronary artery bypass grafting (CABG) using cardiopulmonary bypass (CPB) is associated with a risk of renal dysfunction.
- Multifactorial causes include nonpulsatile flow, hypoperfusion, hypothermia, and CPB duration.
Purpose of the Study:
- To compare the impact of off-pump versus on-pump CABG techniques on postoperative renal function.
Main Methods:
- Sixty patients with normal preoperative renal function undergoing CABG were randomized to on-pump or off-pump procedures.
- Renal function was assessed for up to 10 days postoperatively.
Main Results:
- Off-pump CABG demonstrated significantly higher creatinine clearance (p<.05).
- The off-pump group showed a significantly smaller increase in creatinine levels (p<.05).
- Free water clearance recovery was quicker in the off-pump group (p<.05).
Conclusions:
- The off-pump technique offers significant renal protection following CABG.
- This method may be advantageous for maintaining postoperative renal function in CABG patients.
Background:
Coronary artery bypass grafting (CABG) with cardiopulmonary bypass (CPB) has the risk of renal dysfunction. The cause of renal dysfunction after CPB is multifactorial, such as nonpulsatile flow, renal hypoperfusion, hypothermia, and duration of CPB. This study compared off-pump technique with on-pump technique on renal function in patients who underwent CABG.
Methods:
Sixty patients with normal preoperative renal functions undergoing CABG were randomly assigned to conventional revascularization with CPB (on-pump) or beating heart revascularization (off-pump). Renal functions were assessed up to 10 days postoperatively.
Results:
Creatinine clearance was found to be significantly higher in the off-pump group than in the on-pump group (p<.05). The off-pump group had significantly less increase in creatinine levels when compared with the on-pump group (p<.05). The free water clearance values decreased similarly in both groups; however, the recovery was more prompt in the off-pump group (p<.05). No significant differences were found in the prevalence of postoperative hemodialysis.
Conclusion:
The off-pump technique may provide a positive contribution and sufficient protection on postoperative renal functions in patients undergoing CABG.
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