An intervention that reduces the risk of acute kidney injury may not necessarily improve surgery patients’ long-term kidney function, according to an abstract presented at the American Society of Nephrology’s Kidney Week 2013, “Acute Kidney Injury from Off-Pump or On-Pump Coronary Bypass Grafting and Kidney Function One Year Later (Abstract 5812).”
(Hospitalized patients with acute kidney injury may not be receiving sufficient care after discharge)
Amit Garg, MD, PhD, from the London Health Sciences Centre, in Ontario, and his team designed a study to see if interventions to reduce the risk acute kidney injury (AKI) in hospitalized patients might preserve long-term kidney function. AKI, an abrupt decline in kidney function, is an increasingly prevalent and potentially serious condition following heart surgery; it occurs because the kidneys are deprived of normal blood flow during the procedure. Within the CORONARY trial, investigators assessed kidney function in 2,932 patients from 63 sites in 16 countries who were randomly assigned to coronary-artery bypass grafting (CABG) either with a beating-heart technique (off-pump) or with cardiopulmonary bypass (on-pump).
Off-pump vs on-pump CABG reduced the risk of AKI (17.5% vs 20.8%); however, there was no significant difference between the two groups in the loss of kidney function after one year (17.0% vs. 15.3%).
“The findings emphasize that an intervention that reduces the risk of mild AKI may not necessarily improve long-term kidney function,” the researchers concluded.