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Changes of Renal Function and Treatment after CABG in Patients with Elevated Serum Creatinine  

Choi Jong Bum (Department of Thoracic and Cardiovascular Surgery, Wonkwang University School of Medicine)
Lee Mi Kyuong (Department of Thoracic and Cardiovascular Surgery, Wonkwang University School of Medicine)
Lee Sam Youn (Department of Thoracic and Cardiovascular Surgery, Wonkwang University School of Medicine)
Publication Information
Journal of Chest Surgery / v.38, no.2, 2005 , pp. 146-151 More about this Journal
Abstract
Background: Preoperative elevated serum creatinine values are associated with increased risk for both morbidity and mortality in patients undergoing on-pump coronary artery bypass surgery (CABG). We investigated the postoperative changes of renal function and proper management in the patients. Material and Method: Among 74 consecutive patients who underwent isolated on-pump CABG, 17 patients with increased serum creatinine level $(creatinine\;\geqq\;1.5\;mg/dL)$ within preoperative one week wereincluded in the study. Seven patients showed pre­operative serum creatinine level of 2.0 mg/dL or higher, and 3 of them had been undergoing hemodialysis. Preoperative hemodialysis was performed in the 3 patients due to end-stage renal failure (ESRD) the day before the operation. We started peritoneal dialysis immediately after the cardiopulmonary bypass in patients with ESRD or postoperative acute renal failure if it was necessary to remove intravascular volume and lower serum creatinine level. Result In most of the patients with CABG, postoperative serum creatinine level increased and recovered to the preoperative level at the discharge. In 2 of the 4 patients with serum creatinine level of 2.0 mg/dL or higher and 3 patients with ESRD, intravascular volume, serum creatinine level and serum electrolyte were controlled with peritoneal dialysis. Conclusion: Postoperative serum creatinine level increased transiently in most of CABG patients, and intravascular volume and serum creatinine level were controlled by peritoneal dialysis only in the patients with acute renal failure postoperatively and those depending on hemodialysis.
Keywords
Kidney failure; Coronary artery bypass; Cardiopulmonary bypass; complication; Peritoneal dialysis; Creatinine;
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