Background: There are conflicting reports on the
effects of diltiazem treatment on renal function in surgical patients.
We sought to determine whether diltiazem treatment alters renal
function in patients undergoing major thoracic surgery.
Methods: In a prospective study, 330 patients scheduled for
elective thoracic surgery received either IV diltiazem (n = 167) or
placebo (n = 163) immediately after the operation and orally
thereafter for 14 days in an effort to prevent postoperative atrial
arrhythmias. Serum creatinine and BUN levels were compared before and
during the first postoperative week.
treated with diltiazem were similar to control subjects in terms of age
(mean ±SD, 66 ± 10 years vs 67 ± 10 years,
respectively), baseline serum creatinine or BUN levels, prevalence of
comorbid conditions, and surgical characteristics. During the first 5
postoperative days, the two groups did not differ in terms of serum
creatinine or BUN levels. The incidence of renal failure was 0.6% in
the diltiazem group and 1.2% in the placebo group (difference was not
significant). There was no difference in the length of hospitalization
or mortality rate.
Conclusions: In patients
without renal disease who are undergoing elective thoracic surgery,
prophylactic diltiazem treatment did not alter postoperative renal