Abstract

Acute kidney injury (AKI) is a serious complication after coronary artery bypass grafting and is closely associated with high mortality. Several studies have outlined various risk factors responsible for such occurrences. Does off-pump coronary artery bypass grafting (OPCAB) has any advantages is yet to be established. The present study was conducted with the objective to identify the incidence of AKI after completing OPCAB and also to identify any risk factors associated with such intervention. Methods: Prospective, observational, single - centred study was conducted, including n=200 consecutive isolated OPCAB surgery done based on inclusion/exclusion criteria between May 2019 and Dec 2020 in a tertiary care hospital. Routine preoperative investigations were done, and the standard surgical protocol was followed for OPCAB. Any pre-operative risk factors of the patients, perioperative interventions if any, undertaken and incidences of AKI in the post-operative period were observed by an independent observer during the study. Multivariate analysis was used to evaluate risk factors for AKI after OPCAB. Results: The overall incidence of AKI was 24% (n = 48). All patients had mild AKI (stage 1) only. In this study, diabetic mellitus 34(49.27%) was identified as an independent preoperative risk factor, and use of inotropes like adrenaline 19(47.75%) and noradrenaline 34(48.57%) as an intraoperative risk factors with a p<0.0001. Conclusion: AKI after OPCAB was common. Diabetic mellitus, intraoperative inotropic and vasopressors such as adrenaline and noradrenaline use were associated with more occurrence of AKI after OPCAB.

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