KIDNEY FUNCTION AFTER OFF-PUMP OR ONPUMP CORONARY ARTERY BYPASS GRAFTING IN THE HIGH-RISK SURGICAL PATIENTS
DOI:
https://doi.org/10.48047/Keywords:
ischemic heart disease, Off-pump, CABG, Renal dysfunction, renal insufficiency, Creatinine, surgical complications, high risk.Abstract
Background and Aim
Theoretically, off-pump coronary artery bypass appears to have less impact on kidney function. We estimated
the primary marker of renal dysfunction in patients with high surgical risk who underwent off-pump and onpump coronary artery bypass.
Methods
We retrospectively analysed the 1339 patients with high surgical risk who underwent isolated coronary artery
bypass grafting were. Patients were divided into two groups: Off-pump (n=672) and On-pump (n=667) coronary
artery bypass. We measured kidney function tests for five days after surgery and before discharge and then
compared the results with preoperative levels.
Results
In the On-pump group, a statistically significant increase in creatinine concentration was observed on the fifth
day after surgery (p = 0.0001) and it persisted until the patient's discharge (p = 0,043). In the Off-pump group, a
statistically significant difference was noted on the fifth day (p = 0,054); however, before discharge from
hospital, the statistical significance was not revealed (p = 0,735). The patients with chronic kidney disease after
on-pump CABG had a statistically significant increase in urea level (p = 0,0021) postoperatively, and more
frequent need for hemodialysis Off-pump 2% (n=3), On-pump 7.3% (n=12), p=0.28.
Conclusion
Off-pump coronary artery bypass showed a less negative impact on kidney function than surgery with
extracorporeal circulation and can be recommended for high-risk surgical patients.
