|Table of Contents|

Impact of on-pump versus off-pump coronary artery bypass grafting on postoperative early acute kidney injury

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《第三军医大学学报》[ISSN:1000-5404/CN:51-1095/R]

Issue:
2018年第12期
Page:
1142-1147
Research Field:
临床医学
Publishing date:

Info

Title:

Impact of on-pump versus off-pump coronary artery bypass grafting on postoperative early acute kidney injury

Author(s):

XI Lei WANG Zhengqing LIU Zhigang LIANG Shaojie TENG

LeiDepartment of Cardiovascular Surgery, Teda International Cardiovascular Hospital, Peking Union Medical College & Chinese Academy of Medical Science, Tianjin, 300457, China

Keywords:

acute kidney injury coronary artery bypass grafting extracorporeal circulation prognosis

PACS:
R654.1;R654.2;R692.06
DOI:
-
Abstract:

ObjectiveTo compare the postoperative renal outcomes after on-pump versus conventional offpump coronary artery bypass grafting (CABG) and analyze the risk factors of acute kidney injury (AKI) following CABG. MethodsThe clinical data were retrospectively reviewed for 588 patients [including 425 male and 163 female patients with a mean body mass of (72.57±11.85) kg and a mean age of (67.21±9.35) years] with coronary heart diseases undergoing CABG in our department between January, 2013 and December, 2016. The perioperative data of the patients receiving on-pump CABG and off-pump CABG were compared and the risk factors of postoperative AKI were identified using univariate analysis and logistic regression analysis. ResultsThe overall incidence of AKI after CABG was 12.1% (71/588) in these patients, and the incidence was significantly lower in the off-pump group than in the on-pump group [6.3%(12/192) vs 14.9%(59/396), P<0.05]. Univariate and multivariate regression analyses identified the application of extracorporeal circulation (OR=0.481, 95%CI: 0.244~0.950, P=0.035), a history of hypertension (OR=2.793, 95%CI: 1.402~5.565,  P=0.03), left atrial diameter (OR=1.063, 95%CI: 1.004~1.126, P=0.036), left carotid artery stenosis (OR=2.139, 95%CI: 1.214~3.769, P=0.00), distal venous bridge anastomotic number (OR=1.681, 95%CI: 1.225~2.306, P=0.001) and the use of blood products (OR=4.421, 95%CI: 1.839~10.625, P=0.001) as the independent risk factors for postoperative AKI. ConclusionOffpump beatingheart CABG achieves better shortterm renal outcomes than conventional on-pump CABG, and the preoperative baseline and general condition of the patients should be considered in the surgical planning.

References:

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Last Update: 2018-07-03