A Propensity Score Analysis of Renal Dysfunction in Patients after On-Pump and Off-Pump Coronary Artery Bypass Surgery

Abstract

INTRODUCTION- Cardiovascular disease has emerged as a major health burden worldwide with coronary artery disease [CAD] causing highest mortality and morbidity. Coronary revascularization is the preferred treatment for patients with multivessel CAD. Based on the application of cardiopulmonary bypass [CPB], Coronary revascularization can be on-pump [OPCAB] or off-pump [CABG].The CPB is known to have multifactorial effects on all end-organ functions due to nonpulsatile flow and inflammation response. Renal function alteration is one of the multiple deleterious effects. There have been reports on superior renal function using off-pump CABG . The present study aimed to investigate and compare the prevalence of renal dysfunction in the two techniques [OPCAB versus CABG].<br />METHODS- This was a single-center retrospective study conducted with the data from 199 patients categorized into two groups of off-pump [n=106] and on-pump [n=93]. Renal parameters were monitored on the days 0, 1, 3, 5 after the operation using Glomerular Filtration Rate [GFR]. Creatinine clearance [CrCl] of patients with diabetes, hypertension, both diabetes and hypertension, and normal patients was also correlated.<br />RESULTS- Two groups of on-pump and off-pump were combined and classified according to Propensity Score. Renal functions were compared between the two groups no significant difference in renal function between the off-pump and on-pump groups.<br />CONCLUSION-In the present study, there were no significant differences between the two techniques in renal outcomes. Both groups shared an almost similar change of trends in renal functions.