The impact of minimal invasive extracorporeal circulation on postoperative kidney function

Introduction: Acute kidney injury following cardiac surgery is a frequent complication associated with increased mortality and morbidity. Minimal invasive extracorporeal circulation is suggested to preserve postoperative renal function. The aim of this study was to assess the impact of minimal invas...

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Bibliographic Details
Published in:Perfusion 2021-10, Vol.36 (7), p.745-750
Main Authors: Media, Ara Shwan, Juhl-Olsen, Peter, Magnusson, Nils Erik, Modrau, Ivy Susanne
Format: Article
Language:English
Subjects:
Acute Kidney Injury - etiology
Biomarkers
Cardiac Surgical Procedures
Circulation
Classification
Coronary artery
Coronary Artery Bypass
Epidermal growth factor receptors
Extracorporeal Circulation - adverse effects
Gelatinase
Glomerular filtration rate
Heart surgery
Humans
Injuries
Kidney
Kidneys
Leukocytes (neutrophilic)
Lipocalin
Morbidity
Patients
Renal function
Surgery
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Summary:Introduction: Acute kidney injury following cardiac surgery is a frequent complication associated with increased mortality and morbidity. Minimal invasive extracorporeal circulation is suggested to preserve postoperative renal function. The aim of this study was to assess the impact of minimal invasive versus conventional extracorporeal circulation on early postoperative kidney function. Methods: Randomized controlled trail including 60 patients undergoing elective stand-alone coronary artery bypass graft surgery and allocated in a 1:1 ratio to either minimal invasive (n = 30) or conventional extracorporeal circulation (n = 30). Postoperative kidney injury was assessed by elevation of plasma neutrophil gelatinase-associated lipocalin (NGAL), a sensitive tubular injury biomarker. In addition, we assessed changes in estimated glomerular filtration rate (eGFR), and the incidence of acute kidney injury according to the Acute Kidney Injury Network (AKIN) classification. Results: We observed no differences between groups regarding increase of plasma NGAL (p = 0.31) or decline of eGFR (p = 0.82). In both groups, 6/30 patients developed acute kidney injury according to the AKIN classification, all regaining preoperative renal function within 30 days. Conclusion: Our findings challenge the superiority of minimal invasive compared to conventional extracorporeal circulation in terms of preservation of renal function following low-risk coronary surgery.
ISSN:0267-6591
1477-111X
DOI:10.1177/0267659120954601