title: Existence of renal dysfunction in diabetics undergoing coronary artery bypass.
abstract: BACKGROUND
  The effect of diabetes mellitus on morbidity and mortality in patients undergoing coronary artery bypass grafting has remained uncertain, and conflicting conclusions have been reported in clinical trials. Evidence suggests that coronary artery bypass in patients with diabetes mellitus carries a higher risk of stroke, renal failure, perioperative complications, and sternal wound infection. This study evaluated the frequency of acute renal dysfunction after coronary artery bypass in diabetic patients, and the associated risk factors.
  
  
  METHODS
  This cross-sectional observational study included 135 patients with diabetes (111 males and 24 females with a mean age 51 years and a body mass index of 27.44 kg m(-2)), who underwent elective coronary artery bypass from March 2015 to October 2015. Data were collected prospectively in 2 tertiary care centers. Renal dysfunction was assessed by serum creatinine levels preoperatively and at 24 and 48 h postoperatively.
  
  
  RESULTS
  Fifteen percent of patients were found to have postoperative renal dysfunction. Univariate analysis revealed that patients with increased serum creatinine preoperatively were at greater risk of developing renal dysfunction after coronary artery bypass (p = 0.00). On multivariable binary logistic regression analysis, preoperative serum creatinine level was the only independent predictor of postoperative renal dysfunction; age, body mass index, dyslipidemia, hypertension, cardiopulmonary bypass time, and aortic crossclamp time showed no significant association.
  
  
  CONCLUSIONS
  Diabetic patients with increased serum creatinine preoperatively are at greater risk of kidney damage postoperatively; therefore, these patients should be monitored and treated critically in the perioperative period.
authors.affiliation: Section of Cardiothoracic Surgery, Department of Surgery, Aga Khan University Hospital, Karachi, Pakistan.
authors.forename: Taimur Asif
authors.initials: TA
authors.lastname: Ali
authors.affiliation: Department of Cardiac Surgery, Civil Hospital Karachi, Karachi, Pakistan.
authors.forename: Urooj
authors.initials: U
authors.lastname: Salahuddin
authors.affiliation: Department of Cardiac Surgery, Civil Hospital Karachi, Karachi, Pakistan.
authors.forename: Arfeel
authors.initials: A
authors.lastname: Shoukat
authors.affiliation: Section of Cardiothoracic Surgery, Department of Surgery, Aga Khan University Hospital, Karachi, Pakistan.
authors.forename: Noman
authors.initials: N
authors.lastname: Shahzad
authors.affiliation: Section of Cardiothoracic Surgery, Department of Surgery, Aga Khan University Hospital, Karachi, Pakistan naeem.syedsaad@gmail.com.
authors.forename: Syed Saad
authors.initials: SS
authors.lastname: Naeem
authors.affiliation: Department of Cardiac Surgery, Civil Hospital Karachi, Karachi, Pakistan.
authors.forename: Mudassir Iqbal
authors.initials: MI
authors.lastname: Dar
authors.affiliation: Section of Cardiothoracic Surgery, Department of Surgery, Aga Khan University Hospital, Karachi, Pakistan.
authors.forename: Saulat Hasnain
authors.initials: SH
authors.lastname: Fatimi
mesh_terms: D015415:Biomarkers / Q000097:blood; D002315:Cardiopulmonary Bypass / Q000009:adverse effects; D016009:Chi-Square Distribution; D001026:Coronary Artery Bypass / Q000009:adverse effects*; D003324:Coronary Artery Disease / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D003404:Creatinine / Q000097:blood; D003430:Cross-Sectional Studies; D003928:Diabetic Nephropathies / Q000097:blood / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology; D017558:Elective Surgical Procedures; D005260:Female; D006801:Humans; D007668:Kidney / Q000503:physiopathology*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010154:Pakistan; D011446:Prospective Studies; D051437:Renal Insufficiency / Q000097:blood / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D012307:Risk Factors; D062606:Tertiary Care Centers; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D003404:Creatinine
keywords: Cardiopulmonary bypass; Coronary artery bypass; Diabetes melitis; Renal insufficiency; Risk factors; chronic