Key result
OPCAB cuts postoperative dialysis ~88% vs. on-pump CABG in preexisting renal insufficiency.
Why the study?
The impact of off-pump versus on-pump coronary artery bypass grafting on renal function in patients with nondialysis-dependent renal dysfunction was unclear.
Cohort (n=94)
Randomly assigned
No
Answers are grounded in this paper and cite their sources.
May support off-pump CABG to lower dialysis risk in renal insufficiency; hypothesis-generating and requires prospective confirmation.
BACKGROUND: We aimed to compare off-pump technique with on-pump technique on renal function in patients with nondialysis-dependent renal dysfunction who underwent coronary artery bypass grafting. METHODS: The 94 patients with renal dysfunction undergoing isolated coronary artery bypass grafting were retrospectively analyzed. No patient was receiving dialysis. Patients were randomly assigned to conventional revascularization with cardiopulmonary bypass and beating heart. Both groups were compared in terms of renal dysfunction parameters and dialysis requirement. The logistic regression models were constructed to identify risk factors associated with dialysis requirement. RESULTS: Renal dysfunction requiring dialysis developed in 9 patients in the on-pump group. The measures analysis of variance was performed on the data that showed worsening of renal function in the on-pump group compared with the off-pump group. Cardiopulmonary bypass is significant as independent predictor for the development of postoperative dialysis. CONCLUSION: These results suggest that off-pump coronary revascularization offers a superior renal protection and has a significantly lower risk for renal complications in patients with nondialysis-dependent renal dysfunction when compared with conventional coronary revascularization with cardiopulmonary bypass.
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Arslan et al. (2018) conducted a cohort in Nondialysis-dependent renal dysfunction (n=94). Off-pump coronary artery bypass grafting vs. On-pump coronary artery bypass grafting was evaluated on Renal dysfunction requiring dialysis (p=0.0001). Off-pump coronary artery bypass grafting significantly reduced the incidence of postoperative renal dysfunction requiring dialysis compared to on-pump surgery (2.17% vs 18.75%, p=0.0001) in patients with preexisting nondialysis-dependent renal insufficiency.
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