Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2015, 159(3):449-454 | DOI: 10.5507/bp.2014.023

Differential impact on acute kidney injury incidence between on- and off pump coronary artery bypass grafting in octogenarians

Rudolf Spundaa, Martin Valekb, Myroslav Salmaya, Tomas Prskaveca, Ondrej Pechac, Jaroslav Lindnera, Miroslav Spaceka
a 2nd Department of Surgery - Department of Cardiovascular Surgery, 1st Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Czech Republic
b 2nd Department of Internal Medicine - Department of Cardiovascular Medicine, 1st Faculty of Medicine, Charles University in Prague and General University Hospital in Prague
c Institute of Biophysics and Informatics, 1st Faculty of Medicine, Charles University in Prague

Introduction: Acute kidney injury (AKI) following surgical myocardial revascularization is associated with high mortality and morbidity. The aim of this study was to evaluate the risk of acute kidney injury in a population of very old patients following different surgical techniques.

Patients and Methods: A retrospective study of 310 consecutive patients aged 78 to 93 years, mean 80.5±2.2, who underwent surgery at one cardiac surgery centre. Based on the surgical technique used the patients were divided into: Group I. CABG (n=134) - surgical myocardial revascularization using extracorporeal circulation and arterial and venous grafts. Group II. OPCABG (n=55) - surgical revascularization without extracorporeal circulation but using arterial and venous grafts. Group III. NOTOUCH (n=121) - no handling with the ascending aorta was performed at all.

Results: A statistically insignificant renoprotective trend was found in patients who underwent surgery without extracorporeal circulation regardless of technique. Comparing groups II and III vs. group I, a significantly poorer renal functioning (median difference in creatinine was 10.0 (32.9) vs 17.5 (35.0), P=0.05) was shown for patients in group I.

Conclusion: Surgical myocardial revascularization without extracorporeal circulation in very old patients is safe. The results of this study show a renoprotective trend.

Keywords: acute kidney injury, coronary artery bypass grafting, octogenarians

Received: November 25, 2013; Accepted: April 24, 2014; Prepublished online: May 30, 2014; Published: September 30, 2015  Show citation

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Spunda, R., Valek, M., Salmay, M., Prskavec, T., Pecha, O., Lindner, J., & Spacek, M. (2015). Differential impact on acute kidney injury incidence between on- and off pump coronary artery bypass grafting in octogenarians. Biomedical papers, 159(3), 449-454. doi: 10.5507/bp.2014.023
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