Impact of preoperative renal dysfuntion on short-term outcomes of patients undergoing off-pump coronary artery bypass grafting
European Journal of Molecular & Clinical Medicine,
2022, Volume 9, Issue 3, Pages 11983-11992
AbstractAim: To study the incidence and clinical profile of post-operative acute kidney injury in patients undergoing cardiac surgery.
Materials and Methods: The present prospective descriptive study was conducted at a tertiary care hospital in South India, for the period of 2 years (Jan 2017-Dec 2019) to compare post-operative outcomes in patients with normal and varying degrees of non-dialysis dependant renal insufficiency (NRDI) in patients undergoing off pump Coronary Artery Bypass Grafting (OPCABG). All the patients were categorized into five groups/stages by glomerular filtration rate (GFR). All the relevant data was captured for all patients in the study specific case report forms. At the time of admission to the operation baseline clinical characteristics such as age, sex, obesity, smoking, New York Heart Association (NYHA) class, previous myocardial infarction (MI), percutaneous coronary intervention (PCI), diabetes mellitus (DM), hypertension, hyperlipidaemia, chronic obstructive pulmonary disease (COPD), Left ventricular ejection fraction (LVEF), prior CVA, eGFR, serum creatinine, anatomical severity of coronary artery disease (CAD). Operative data like number of grafts, type of conduit, target artery and postoperative details such as major adverse cardiac cerebrovascular events were collected.
Results: Patients in severe group showed higher rates of comorbidities when compared with mild, moderate and normal groups. Mean number of grafts used were similar between the groups (p=0.49). Even though percentage of re-exploration for bleeding did not show any significant difference (p=0.40) among the group, patients in severe group showed high percentage of re-explorations.
Conclusion: There was no significant difference in the patients undergoing off-pump CABG with normal, mild, moderate and severe renal functions in terms of short-term mortality. Off-pump CABG is more reno-protective for patients with normal renal function.
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