title: Is it necessary to stent renal artery stenosis patients before cardiopulmonary bypass procedures?
abstract: BACKGROUND
  Acute kidney injury (AKI) is associated with poor prognosis after cardiopulmonary bypass. The aim of this retrospective study was to investigate whether stent implantation before cardiopulmonary bypass has beneficial effect on development of AKI in renal artery stenosis (RAS) patients.
  
  
  METHODS
  In this retrospective study, patients with abnormal baseline serum creatinine (SCr, > 106 µmol/L) were not included. Included patients (n = 69) were divided into two groups. Group 1 included 31 RAS patients receiving no stent implantation before cardiopulmonary bypass. Group 2 included 38 RAS patients having received stent implantation just before cardiopulmonary bypass. To assess AKI after cardiopulmonary bypass, serum urea nitrogen, SCr and creatinine clearance were recorded at baseline, at the end of operation, during the first and second postoperative 24 hours.
  
  
  RESULTS
  Baseline characteristics were similar between groups. Serum urea nitrogen, SCr, creatinine clearance before and after cardiopulmonary bypass were also similar class groups. Incidence of AKI in group 1 was not significantly different from group 2. In group 1, AKI defined by RIFLE between occurred in 7 (22.6%) patients: 5 (16.1%) with RIFLE-R, 2 (6.5%) with RIFLE-I, and no patients with RIFLE-F. In group 2, 10 patients (26.3%) had an episode of AKI during hospitalization: 6 (15.8%) had RIFLE-R, 4 (10.5%) had RIFLE-I, and no patients had RIFLE-F.
  
  
  CONCLUSIONS
  There are no data suggesting that it is necessary to stent RAS patients with normal SCr before cardio-pulmonary bypass. However, it cannot be concluded that RAS is not associated with AKI after cardiopulmonary bypass.
authors: Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China.
authors: Bin
authors: B
authors: Zheng
authors: Hong-Bing
authors: HB
authors: Yan
authors: Rui-Fang
authors: RF
authors: Liu
authors: Shu-Juan
authors: SJ
authors: Cheng
authors: Jian
authors: J
authors: Wang
authors: Han-Jun
authors: HJ
authors: Zhao
authors: Li
authors: L
authors: Song
mesh_terms: D000368:Aged; D002315:Cardiopulmonary Bypass / Q000379:methods*; D005260:Female; D006439:Hemodynamics; D006801:Humans; D007677:Kidney Function Tests; D008297:Male; D008875:Middle Aged; D012078:Renal Artery Obstruction / Q000601:surgery*; D012189:Retrospective Studies