Key result
Off-pump coronary artery bypass maintained baseline creatinine clearance on days 1, 2, and 4 post-surgery, whereas on-pump surgery caused significant deterioration.
Why the study?
Does off-pump coronary artery bypass grafting improve renal outcomes compared to on-pump CABG in patients with preexisting non-dialysis-dependent renal dysfunction?
Cohort (n=64)
Does off-pump coronary artery bypass grafting improve renal outcomes compared to on-pump CABG in patients with preexisting non-dialysis-dependent renal dysfunction?
Off-pump CABG provides better early renal protection than on-pump CABG in patients with preexisting non-dialysis-dependent renal dysfunction, although renal function normalizes in both groups by 4 weeks.
May support off-pump CABG for early renal preservation in dysfunction; leaves open randomized confirmation of lasting benefit.
A prospective study was carried out to compare the outcomes of patients with preexisting non-dialysis-dependent renal dysfunction who underwent coronary artery bypass grafting with or without cardiopulmonary bypass. Elective off-pump coronary artery bypass was performed in 29 patients with renal dysfunction. Their results were compared with those of a similar group of 35 patients who underwent the conventional on-pump coronary artery grafting. There was a significant deterioration in creatinine clearance in the on-pump group on days 1, 2, and 4 after surgery, while creatinine clearance in the off-pump group remained close to the baseline level. Both groups had improved to the preoperative creatinine clearance values on follow-up at 4 weeks. It was concluded that off-pump surgery provided better renal protection than the conventional on-pump technique in patients with preexisting non-dialysis-dependent renal dysfunction.
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Ooi et al. (2008) conducted a cohort in Preexisting non-dialysis-dependent renal dysfunction (n=64). Off-pump coronary artery bypass vs. Conventional on-pump coronary artery grafting was evaluated on Creatinine clearance. Off-pump coronary artery bypass maintained baseline creatinine clearance on days 1, 2, and 4 post-surgery, whereas on-pump surgery caused significant deterioration.