Acute Renal Failure After Cardiopulmonary Bypass: A Possible Association With Drugs of the Fibrate Group

Background: Renal failure is a recognized, but infrequent, complication following cardiac surgery. The causes for this condition are multifactorial, and a major concern is that the occurrence of postoperative acute renal failure is still associated with a high mortality rate. Methods and Materials:...

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Published in:Journal of cardiovascular pharmacology and therapeutics 2000, Vol.5 (1), p.33-39
Main Authors: Sharobeem, Kamel M., Madden, Brendan P., Millner, Russell, Rolfe, Lindsey M., Seymour, Carol A., Parker, John
Format: Article
Language:English
Subjects:
Acute Kidney Injury - etiology
Aged
Anticholesteremic Agents - adverse effects
Bezafibrate - adverse effects
Cardiopulmonary Bypass - adverse effects
Clofibric Acid - adverse effects
Clofibric Acid - analogs & derivatives
Female
Fibric Acids
Humans
Male
Middle Aged
Rhabdomyolysis - etiology
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Summary:Background: Renal failure is a recognized, but infrequent, complication following cardiac surgery. The causes for this condition are multifactorial, and a major concern is that the occurrence of postoperative acute renal failure is still associated with a high mortality rate. Methods and Materials: We report unexpected acute renal failure occurring in 4 patients after uncomplicated cardiac surgery. Each patient was taking a fibric acid derivative at the time of surgery. Renal failure occurred rapidly within 3 days of surgery and was associated with increased concentrations of skeletal muscle-derived creatine kinase (CK). One patient devel oped myoglobinuria, and another developed a malignant hyperthermia-like syndrome. Conclusions: These cases show that patients receiving lipid lowering medications could be at higher risk of developing acute renal failure after cardiac surgery. This association merits careful evaluation in large prospective studies and, if proved, would suggest that patients taking either statins or fibrates should discontinue doing so before cardiac surgery.
ISSN:1074-2484
1940-4034
DOI:10.1177/107424840000500105