title: Does off-pump coronary artery bypass grafting beneficially affect renal function?
abstract: BACKGROUND
  Off-pump coronary artery bypass grafting (CABG) has been reported to beneficially affect renal function, but this remains to be confirmed. The purpose of the present paper was to study the effects of off-pump CABG on renal function and analyse predictors of postoperative renal impairment in patients who received off-pump CABG.
  
  
  METHODS
  A total of 451 patients who underwent isolated CABG between January 1999 and August 2003 were retrospectively studied. No patient was receiving dialysis. A total of 300 patients (228 men) underwent off-pump CABG (off-pump group) and 151 patients (104 men) underwent on-pump CABG (on-pump group). Perioperative serum creatinine levels and creatinine ratios (peak postoperative creatinine level/preoperative creatinine level) were compared between the groups.
  
  
  RESULTS
  Renal impairment (serum creatinine >1.5 mg/dL) developed postoperatively in 12.7% of the off-pump group and 18.5% of the on-pump group (P = 0.1). The creatinine ratio was significantly lower in the off-pump group (1.2 +/- 0.4) than in the on-pump group (1.4 +/- 0.7, P = 0.003). Logistic regression analysis demonstrated that the strongest predictors of postoperative renal impairment in off-pump CABG were left ventricular dysfunction (odds ratio 10.8) and multivessel grafting (odds ratio 4.3).
  
  
  CONCLUSIONS
  Off-pump CABG provides better renal protection than on-pump CABG. However, perioperative renal function should be closely monitored in patients who have left ventricular dysfunction or who undergo multivessel grafting, even when off-pump CABG is performed.
authors.affiliation: Department of Cardiovascular Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan. m-ogawa@koto.kpu-m.ac.jp
authors.forename: Mitsugu
authors.initials: M
authors.lastname: Ogawa
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Yaku
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Doi
authors.forename: Takahisa
authors.initials: T
authors.lastname: Okano
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Yamada
authors.forename: Kyoko
authors.initials: K
authors.lastname: Hayashida
authors.forename: Atsushi
authors.initials: A
authors.lastname: Fukumoto
mesh_terms: D000368:Aged; D001026:Coronary Artery Bypass; D047549:Coronary Artery Bypass, Off-Pump; D003404:Creatinine / Q000097:blood; D005260:Female; D006801:Humans; D007668:Kidney / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care; D011183:Postoperative Complications
chemical_list: D003404:Creatinine