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Schopka, Simon ; Diez, Claudius ; Camboni, Daniele ; Floerchinger, Bernhard ; Schmid, Christof ; Hilker, Michael

Impact of cardiopulmonary bypass on acute kidney injury following coronary artery bypass grafting: a matched pair analysis

Schopka, Simon, Diez, Claudius, Camboni, Daniele, Floerchinger, Bernhard, Schmid, Christof and Hilker, Michael (2014) Impact of cardiopulmonary bypass on acute kidney injury following coronary artery bypass grafting: a matched pair analysis. Journal of Cardiothoracic Surgery 9 (20).

Date of publication of this fulltext: 19 Mar 2014 11:50
Article
DOI to cite this document: 10.5283/epub.29623


Abstract

Background: Postoperative Acute Kidney Injury (AKI) after coronary artery bypass grafting (CABG) is a common complication associated with significant morbidity and mortality. Cardiopulmonary bypass (CPB) is accepted to contribute to the occurrence of AKI and is of particular importance as it can be avoided by using the off-pump technique. However the renoprotective properties of off-pump (CABG) ...

Background: Postoperative Acute Kidney Injury (AKI) after coronary artery bypass grafting (CABG) is a common complication associated with significant morbidity and mortality. Cardiopulmonary bypass (CPB) is accepted to contribute to the occurrence of AKI and is of particular importance as it can be avoided by using the off-pump technique. However the renoprotective properties of off-pump (CABG) are controversial. This analysis evaluates the impact of cardiopulmonary bypass on renal function. Methods: A matched-pair analysis of 1428 patients undergoing coronary artery bypass grafting was conducted. The patients were stratified according to their preoperative renal function and to risk factors for postoperative AKI. The development of the glomerular filtration rate (GFR) from before surgery until hospital discharge was analyzed. Incidence of AKI were analyzed. Furthermore the impact of CPB duration on postoperative GFR was assessed. Results: The occurrence of AKI increases the risk of thirty-day mortality (odds ratio of 4.3). The postoperative GFR decreases significantly after coronary artery bypass grafting but does not differ between onpump and offpump CABG (60.2 +/- 24.5 vs 60.7 +/- 24.8; p = 0.54). No difference regarding the incidence (26.6% vs 25%) and severity of AKI between cardiopulmonary bypass and the off-pump technique could be found. Duration of cardiopulmonary bypass does not correlate with the decline in postoperative glomerular filtration rate (Pearson Product Moment Correlation; p > 0.050). Conclusion: Neither the mere use nor duration of cardiopulmonary bypass proofed to be a risk factor for developing postoperative AKI in CABG patients with a comparable preoperative risk profile for postoperative renal dysfunction. Furthermore, the severity of postoperative AKI is not affected by the use of cardiopulmonary bypass.



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Details

Item typeArticle
Journal or Publication TitleJournal of Cardiothoracic Surgery
Publisher:BMC
Open Access Type:Gold (with APC)
Place of Publication:LONDON
Volume:9
Number of Issue or Book Chapter:20
Date18 January 2014
InstitutionsMedicine > Lehrstuhl für Herz-, Thorax- und herznahe Gefäßchirurgie
Identification Number
ValueType
10.1186/1749-8090-9-20DOI
KeywordsACUTE-RENAL-FAILURE; OFF-PUMP; ON-PUMP; SERUM CREATININE; MYOCARDIAL REVASCULARIZATION; EXTRACORPOREAL-CIRCULATION; CARDIAC-SURGERY; DYSFUNCTION; MORTALITY; PROGNOSIS; Cardiopulmonary bypass; Coronary artery bypass grafting; Acute kidney injury
Dewey Decimal Classification600 Technology > 610 Medical sciences Medicine
StatusPublished
RefereedYes, this version has been refereed
Created at the University of RegensburgYes
URN of the UB Regensburgurn:nbn:de:bvb:355-epub-296239
Item ID29623

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