Volume 31 Number 3 (2022)

Early Impact of Cardiopulmonary Bypass on Renal Function after Valve Replacement Surgery

Howlader SS1 , Gupta SD2 , Momen A3 , Rahman MH4 , Biswas PK5 , Sarkar SR6 , Rahman KS7 , Chanda PK8 , Ahmed F9

Mymensingh Med J 2022 Jul; 31 (3): 711-718

PMID: 35780355

Abstract

Renal dysfunction following cardiopulmonary bypass is well recognized. The pathophysiology of renal injury is multifactorial and culmination of the interplay of several pathophysiological mechanism. Cardiac surgery requiring cardiopulmonary bypass (CPB) is being carried out on an extended patient population of different age groups and undergoing complex surgical procedure, and thus it places them at an increased risk of renal impairment. Valve replacement surgery is a major and complex surgical procedure requiring CPB. This study was therefore designed to observe the impact of CPB and short term outcome on patients with reduced estimated Glomerular Filtration Rate (eGFR) (60-89ml/min/1.73m2) after valve replacement surgery. This cross-sectional study was conducted in the Department of Cardiac Surgery, National Institute of Cardio Vascular Diseases (NICVD) during the period of January 2015 to August 2016. After fulfillment of enrollment criteria 100 patients were studied for the purpose of the study and they were grouped in two, patients with normal eGFR (≥90ml/min/1.73m2) in Group A and patients with reduced eGFR (60-89ml/min/1.73m2) in Group B. A total of 100 patients, 50 in each group were studied for renal function alteration after valve replacement surgery under cardiopulmonary bypass. The incidence of Acute Kidney Injury (AKI) was higher in Group B. Chi-square test was done and p value was 0.011 which is statistically significant. Postoperative blood loss (ml/hr) (p=0.038), duration of  Intensive Care Unit (ICU) stay (in hours) (p=0.009), postoperative hospital stay (days) (p=0.014) was significantly higher and postoperative Urine Output (ml/hr) (p=0.001) was significantly lower in patients with reduced eGFR (60-89ml/min/1.73m2) in Group B. Deterioration of renal function is more in patient with eGFR (60-89ml/min/1.73m2) after valve replacement surgery under cardiopulmonary bypass in comparison with patients with eGFR (≥90ml/min/1.73m2). 

Keywords: Estimated glomerular filtration rate (eGFR), Acute kidney injury (AKI), Cardiopulmonary bypass (CPB), Valve replacement surgery


  1. Senior Specialist

    Department of Cardiothoracic and Vascular Surgery, Evercare Hospital Chattogram, Bangladesh

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Volume 31, Number 3 (2022)
Page: 711-718