A Propensity Score Analysis of Renal Dysfunction in Patients after On-Pump and Off-Pump Coronary Artery Bypass Surgery

INTRODUCTION: Cardiovascular disease has emerged as a major health burden worldwide with coronary artery disease [CAD] causing highest mortality and morbidity. Coronary revascularization is the preferred treatment for patients with multivessel CAD. Based on the application of cardiopulmonary bypass [CPB], Coronary revascularization can be onpump [OPCAB] or offpump [CABG].The CPB is known to have multifactorial effects on all endorgan functions due to nonpulsatile flow and inflammation response. Renal function alteration is one of the multiple deleterious effects. There have been reports on superior renal function using offpump CABG . The present study aimed to investigate and compare the prevalence of renal dysfunction in the two techniques [OPCAB versus CABG]. METHODS: This was a singlecenter retrospective study conducted with the data from 199 patients categorized into two groups of offpump [n=106] and onpump [n=93]. Renal parameters were monitored on the days 0, 1, 3, 5 after the operation using Glomerular Filtration Rate [GFR]. Creatinine clearance [CrCl] of patients with diabetes, hypertension, both diabetes and hypertension, and normal patients was also correlated. RESULTS: Two groups of onpump and offpump were combined and classified according to Propensity Score. Renal functions were compared between the two groups no significant difference in renal function between the offpump and onpump groups.CONCLUSION: In the present study, there were no significant differences between the two techniques in renal outcomes. Both groups shared an almost similar change of trends in renal functions.