Korean J Anesthesiol.  2010 Feb;58(2):142-147. 10.4097/kjae.2010.58.2.142.

Impact of the interval between coronary angiography and off-pump coronary bypass surgery on postoperative renal function

• Kim NY
• Kim SY
• Lee NH
• Kwak YL

• KMID: 2092269
• DOI: http://doi.org/10.4097/kjae.2010.58.2.142

Abstract

BACKGROUND
Postoperative acute kidney injury (AKI) is a significant complication after coronary artery bypass surgery. Prior coronary angiography increases the likelihood of AKI due to the use of a radiocontrast dye. This study examined the effect of coronary angiography on the postoperative renal function after off-pump coronary artery bypass surgery (OPCAB). METHODS: The records of 110 patients who required OPCAB were reviewed. These patients also had at least two of the following conditions: chronic kidney disease, hypertension, diabetes mellitus, emergency surgery, congestive heart failure, age >75 years, hematocrit <30%, a left ventricular ejection fraction <40%, or the use of angiotensin-converting enzyme inhibitors or angiotensin receptor blockers. The patients were divided into two groups; coronary angiography performed within two days of OPCAB (Control group, n = 55), and coronary angiography performed more than two days before OPCAB (Angio group, n = 55). The serum creatinine (SCr) and serum cystatin C levels were measured on the day before surgery, as well as on postoperative days 1, 2, 3 and 7. The estimated glomerular filtration rate (eGFR) was also obtained on those days. AKI was defined as an increase in Cr > or =50% or > or =0.3 mg/dl within 48 hours. RESULTS: The postoperative changes in the SCr, cystatin C and eGFR were similar in the two groups. The incidence of AKI and renal replacement therapy were similar in the two groups. CONCLUSIONS: Coronary angiography performed within two days of OPCAB does not affect the postoperative renal function.

Keyword

Coronary angiography; Kidney; Off-pump coronary artery bypass; Postoperative periods

MeSH Terms

Acute Kidney Injury
Angiotensin Receptor Antagonists
Angiotensin-Converting Enzyme Inhibitors
Coronary Angiography
Coronary Artery Bypass
Coronary Artery Bypass, Off-Pump
Creatinine
Cystatin C
Diabetes Mellitus
Emergencies
Glomerular Filtration Rate
Heart Failure
Hematocrit
Humans
Hypertension
Incidence
Kidney
Postoperative Period
Renal Insufficiency, Chronic
Renal Replacement Therapy
Stroke Volume
Angiotensin Receptor Antagonists
Angiotensin-Converting Enzyme Inhibitors
Creatinine
Cystatin C