Acute Renal Failure After Open Heart Surgery

Abstract

This study included 100 patients who underwent open heart surgery at Cairo University hospitals, Cardiothoracic Surgery Department, for valve replacement or repair, total correction of congenital heart defects and coronary artery bypass grafting, to evaluate the effect of 4 different drugs in the prevention of postoperative acute tubular necrosis following open heart surgery; these drugs are:

• The oxygen scavenging agent (allopurinol). • The strong antioxidant formula (antox). • The calcium channel blocker (diltiazem). • The ACE-inhibitor (captopril). • The patients were classified into 5 groups matching in age, gender, indications for surgery and their preoperative cardiac and kidney functions.

All the groups received the drug one week before surgery and continued for another week after surgery. For assessment of the renal functions, urine and blood samples were taken preoperatively, 1'\ 4th and 7th postoperative days for determination of the following parameters. All patients in the 5 groups during the first postoperative week showed significant increase in the blood urea, serum creatinine and significant decrease in the creatinine clearance as well as significant increase in the 24 hours. Albumin in urine. On the other hand, there was no significant difference in the urine pH postoperatively versus preoperatively.