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
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 developed 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.
Sharobeem
K M
KM
Division of Cardiological Sciences, St. George's Hospital Medical School, London, UK.
Madden
B P
BP
Millner
R
R
Rolfe
L M
LM
Seymour
C A
CA
Parker
J
J
D058186:Acute Kidney Injury / Q000209:etiology*; D000368:Aged; D000924:Anticholesteremic Agents / Q000009:adverse effects*; D001629:Bezafibrate / Q000009:adverse effects*; D002315:Cardiopulmonary Bypass / Q000009:adverse effects*; D002995:Clofibric Acid / Q000009:adverse effects / Q000031:analogs & derivatives*; D005260:Female; D058607:Fibric Acids; D006801:Humans; D008297:Male; D008875:Middle Aged; D012206:Rhabdomyolysis / Q000209:etiology
D000924:Anticholesteremic Agents; D058607:Fibric Acids; D002995:Clofibric Acid; C019304:ciprofibrate; D001629:Bezafibrate