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Cardiothoracic Surgery |

Evaluation of Renal Function Before and After Cardiovascular Surgery

Katsuhito Teranishi*, MD
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Chubu Rosai Hospital, Nagoya, Japan


Chest. 2012;142(4_MeetingAbstracts):64A. doi:10.1378/chest.1388272
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Abstract

SESSION TYPE: Thoracic Surgery Posters I

PRESENTED ON: Wednesday, October 24, 2012 at 01:30 PM - 02:30 PM

PURPOSE: Renal dysfunction is one of major complications after cardiovascular surgery. Age, cardiopulmonary bypass (CPB) and other factors may affect the postoperative renal function. Changes of renal function before and after the surgery were examined.

METHODS: Data from 266 patients who received 24 hours creatinine clearance test (Ccr)(L/day) before the cardiovascular surgery between October 2003 and December 2011 were reviewed. Preoperative serum creatinine (Cr)(mg/dl), Ccr, postoperative peak Cr (pCr)(mg/dl), and the period (POD) between the operation and day of pCr, the ratio of pCr/Cr were analyzed. Patients were divided into two groups by Ccr, Cr(H)(Cr>=70) and Cr(L)(Cr<70), and also, into two groups with or without CPB (CPB(+)and CPB(-)). Patients were divided into four groups by age, A50 (<60), A60 (60-69), A70 (70-79) and A80 (80<=).

RESULTS: They were 167 males and 99 females, and the mean age was 67.6 years old. The average Ccr, Cr, pCr, pCr/Cr and POD (day) were 75.3, 1.00, 1.36, 1.35 and 3.3, respectively, and negative correlation was observed between Ccr and Cr. Those were 101.1, 0.77, 0.95, 1.25 and 2.9 in Ccr(H)(N=132), 49.9, 1.23, 1.76, 1.45 and 3.8 in Ccr(L)(N=134), respectively. Those were 77.8, 0.95, 1.35, 1.42 and 2.8 in CPB(+)(N=136), and 72.8, 1.05, 1.38, 1.29 and 3.9 in CPB(-)(N=130), respectively. Renal function deteriorated in elder group, and Cr and pCr were getting higher than younger group. Although no significant difference of Ccr and Cr were observed between CPB(+) and CPB(-), pCr/Cr of CPB(+) was significant higher than that of CPB(-).

CONCLUSIONS: Attention should be paid to patients whose preoperative Cr were less than 70 even though Ccr were within normal. pCr/Cr level in CPB(+) was higher than that in CPB(-), suggesting that CPB could be affected postoperative renal function. The preoperative renal function in elder patients was worse than younger patients, postoperative renal function got worse.

CLINICAL IMPLICATIONS: In addition, diabetes might affect renal function, and attention should be paid after the operation in patients with complications

DISCLOSURE: The following authors have nothing to disclose: Katsuhito Teranishi

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Chubu Rosai Hospital, Nagoya, Japan

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