Online ISSN: 2515-8260

Keywords : GFR

Impact of preoperative renal dysfuntion on short-term outcomes of patients undergoing off-pump coronary artery bypass grafting

Prerna Singh, Mayank Swarnkar, Saraansh Bansal, Dr. G. Ramasubrahmanium

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 11983-11992

Aim: To study the incidence and clinical profile of post-operative acute kidney injury in patients undergoing cardiac surgery.
Materials and Methods: The present prospective descriptive study was conducted at a tertiary care hospital in South India, for the period of 2 years (Jan 2017-Dec 2019) to compare post-operative outcomes in patients with normal and varying degrees of non-dialysis dependant renal insufficiency (NRDI) in patients undergoing off pump Coronary Artery Bypass Grafting (OPCABG). All the patients were categorized into five groups/stages by glomerular filtration rate (GFR). All the relevant data was captured for all patients in the study specific case report forms. At the time of admission to the operation baseline clinical characteristics such as age, sex, obesity, smoking, New York Heart Association (NYHA) class, previous myocardial infarction (MI), percutaneous coronary intervention (PCI), diabetes mellitus (DM), hypertension, hyperlipidaemia, chronic obstructive pulmonary disease (COPD), Left ventricular ejection fraction (LVEF), prior CVA, eGFR, serum creatinine, anatomical severity of coronary artery disease (CAD). Operative data like number of grafts, type of conduit, target artery and postoperative details such as major adverse cardiac cerebrovascular events were collected.
Results: Patients in severe group showed higher rates of comorbidities when compared with mild, moderate and normal groups. Mean number of grafts used were similar between the groups (p=0.49). Even though percentage of re-exploration for bleeding did not show any significant difference (p=0.40) among the group, patients in severe group showed high percentage of re-explorations.
Conclusion: There was no significant difference in the patients undergoing off-pump CABG with normal, mild, moderate and severe renal functions in terms of short-term mortality. Off-pump CABG is more reno-protective for patients with normal renal function.

Low Dose Aspirin Therapy and Renal Function in Elderly Patients: An Institutional Based Study

Javed Yusuf Shah, Javed Nilofar Shah

European Journal of Molecular & Clinical Medicine, 2017, Volume 4, Issue 1, Pages 293-297

Introduction: The use of aspirin as a pain reliever has been in use for the past 10 years.
Its therapeutic use has also been proven to prevent heart attack and other related
ailments. Elderly individuals who are at greater risk are mostly prescribed low dose
aspirin as an anti-platelet drug to prevent thrombosis.
Materials and Methodology: Aspirin drug with a dose of 100 mg/day was administered
either through oral route or by a nasogastric tube after having breakfast for a period of
2 weeks and then the drug was stopped, and the investigations were continued for a
further 3 weeks. Blood samples and 24hour urine samples were collected every week:
before the administration of first dose of aspirin, and at the end of every treatment
week, and continued for further 3 consecutive weeks after the discontinuity of aspirin
drug. Student’s paired t-test is used to check for the weekly changes of all
measurements compared to baseline, multivariate analysis of variance with repeated
measures (MANOVA) for the overall effect of aspirin drug during the study period.
Results: A highly significant association between the variations from baseline to week 2
in both creatinine and Cu acid was recorded (r = 0.7, P < 0.0001). However, such
correlations were not found between changes in values of C-G and Cu acid. The
decrease in Ccr was also influenced by low haemoglobin levels (R2 = 0.075, P = 0.006)
and by albumin levels with borderline significance (R2 = 0.027, P = 0.08).
Conclusion: The results of the present study might directly reflect that the low dose
aspirin administration in elderly inpatients for a relatively briefer period of time has a
significant effect on their renal tubular function; hence a long-term drug intake may
have some major harmful effect on renal activity. These findings have received a major
necessity to conduct further research in younger and healthier patients and also on
long-term usage of aspirin therapy