Shao-Wei Chen1,2,3, Chih-Hsiang Chang2,4,3, Yen Chu1, Victor Chien-Chia Wu5, Cheng-Chia Lee2,4,3, Dong-Yi Chen5, Pyng-Jing Lin1, Feng-Chun Tsai1. 1. Department of Cardiothoracic and Vascular Surgery, Chang Gung Memorial Hospital, Linkou Medical Center, Chang Gung University. 2. Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University. 3. Chang Gung Cardio-Renal Study Group, Taoyuan, Taiwan. 4. Kidney Research Center, Department of Nephrology. 5. Department of Cardiology, Chang Gung Memorial Hospital, Linkou Medical Center.
Abstract
BACKGROUND: The aim of this investigation is to compare the postoperative renal outcomes after on-pump beating- heart versus conventional cardioplegic arrest coronary artery bypass grafting (CABG). METHODS: Between January 2010 and December 2012, 254 patients who underwent isolated CABG were enrolled. The primary outcome was postoperative acute kidney injury (AKI) within 7 days [defined by the Kidney Disease Improving Global Outcome (KDIGO) Clinical Practice Guideline] and loss of kidney function at 1 year (defined as > 20% loss in estimated glomerular filtration rate from baseline preoperative creatinine level). RESULTS: There was less AKI found for the on-pump beating-heart CABG (30.2% versus 46.3%; p = 0.010) group; with significant less stage I AKI (17.6% versus 29.5%; p = 0.035); a trend of less stage II AKI (4.4% versus 10.5%; p = 0.088) and no significant difference in stage III AKI (8.2% versus 6.3%; p = 0.587). The on-pump beating-heart group also had less patients who have lost their kidney function at 1 year (24.8% versus 41.2%; p = 0.021). Furthermore, multivariate analysis identified conventional arrest CABG is an independent risk factor for postoperative AKI and loss of kidney function at 1 year. CONCLUSIONS: On-pump beating-heart CABG has superior short-term and mid-term renal outcomes than conventional cardioplegic arrest CABG.
BACKGROUND: The aim of this investigation is to compare the postoperative renal outcomes after on-pump beating- heart versus conventional cardioplegic arrest coronary artery bypass grafting (CABG). METHODS: Between January 2010 and December 2012, 254 patients who underwent isolated CABG were enrolled. The primary outcome was postoperative acute kidney injury (AKI) within 7 days [defined by the Kidney Disease Improving Global Outcome (KDIGO) Clinical Practice Guideline] and loss of kidney function at 1 year (defined as > 20% loss in estimated glomerular filtration rate from baseline preoperative creatinine level). RESULTS: There was less AKI found for the on-pump beating-heart CABG (30.2% versus 46.3%; p = 0.010) group; with significant less stage I AKI (17.6% versus 29.5%; p = 0.035); a trend of less stage II AKI (4.4% versus 10.5%; p = 0.088) and no significant difference in stage III AKI (8.2% versus 6.3%; p = 0.587). The on-pump beating-heart group also had less patients who have lost their kidney function at 1 year (24.8% versus 41.2%; p = 0.021). Furthermore, multivariate analysis identified conventional arrest CABG is an independent risk factor for postoperative AKI and loss of kidney function at 1 year. CONCLUSIONS: On-pump beating-heart CABG has superior short-term and mid-term renal outcomes than conventional cardioplegic arrest CABG.
Authors: Victor F Seabra; Sami Alobaidi; Ethan M Balk; Alan H Poon; Bertrand L Jaber Journal: Clin J Am Soc Nephrol Date: 2010-07-29 Impact factor: 8.237
Authors: Paul M Palevsky; Kathleen D Liu; Patrick D Brophy; Lakhmir S Chawla; Chirag R Parikh; Charuhas V Thakar; Ashita J Tolwani; Sushrut S Waikar; Steven D Weisbord Journal: Am J Kidney Dis Date: 2013-03-15 Impact factor: 8.860
Authors: K Karkouti; W S Beattie; D N Wijeysundera; V Rao; C Chan; K M Dattilo; G Djaiani; J Ivanov; J Karski; T E David Journal: J Thorac Cardiovasc Surg Date: 2005-02 Impact factor: 5.209
Authors: Sean Gallagher; Dan A Jones; Matthew J Lovell; Sevda Hassan; Andrew Wragg; Akhil Kapur; Rakesh Uppal; Muhammad M Yaqoob Journal: J Thorac Cardiovasc Surg Date: 2013-04-12 Impact factor: 5.209
Authors: Nanette M Schwann; Jay C Horrow; Michael D Strong; Dmitri Chamchad; Albert Guerraty; Andrew S Wechsler Journal: Anesth Analg Date: 2004-10 Impact factor: 5.108