Key result
Off-pump coronary artery bypass grafting significantly better preserved renal function compared to on-pump grafting, evidenced by higher creatinine clearance on post-operative day 1 (46.6 vs 34.7 mL/min, p<0.001).
Why the study?
The study was conducted to compare renal function in patients with pre-operative impaired renal function undergoing off-pump versus on-pump coronary artery bypass grafting.
Does off-pump coronary artery bypass grafting improve post-operative renal function compared to on-pump coronary artery bypass grafting in patients with pre-operative impaired renal function?
Observational (n=100)
Randomly selected
No
Does off-pump coronary artery bypass grafting improve post-operative renal function compared to on-pump coronary artery bypass grafting in patients with pre-operative impaired renal function?
Absolute Event Rate: 46.6% vs 34.7%
p-value: p=<0.001
Off-pump CABG better preserves renal function compared to on-pump CABG in patients with pre-existing renal impairment.
Off-pump may better preserve renal function in impaired patients; hypothesis-generating and requires randomized confirmation before practice change.
The purpose of this study was to compare the renal function in patients undergoing coronary artery bypass grafting in off-pump and on-pump having pre-operative impaired renal function. In the on-pump, the serum creatinine and urea levels were significantly increased on post-operative day 1, 3 and 7. On day 1, it was maximum, then gradually decreased but not reached to pre-operative level. In case of off-pump, serum creatinine and urea levels were significantly increased on post-operative day 1 and 3. On day 1, it was maximum. Then decreased and the serum creatinine reached below pre-operative level on day 7. In case of on-pump, the creatinine clearance rate was significantly decreased on post-operative day 1, 3 and 7. On day 1, it was minimum. Then gradually increased but not reached the pre-operative level. In case off-pump, the creatinine clearance rate was significantly decreased on day 1 and 3. On day 1, it was minimum, then gradually increased and reached above the pre-operative level. A significant low level creatinine clearance rate was observed in on-pump group. Renal function was better preserved in patients undergoing off-pump in comparison to on-pump coronary artery bypass grafting.
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Alauddin et al. (2019) conducted an observational in Pre-operative impaired renal function requiring elective coronary artery bypass grafting (n=100). Off-pump coronary artery bypass grafting vs. On-pump coronary artery bypass grafting was evaluated on Creatinine clearance on post-operative day 1 (mL/min) (p=<0.001). Off-pump coronary artery bypass grafting significantly better preserved renal function compared to on-pump grafting, evidenced by higher creatinine clearance on post-operative day 1 (46.6 vs 34.7 mL/min, p<0.001).
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