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Effects of renin-angiotensin system inhibitors on the occurrence of acute kidney injury following off-pump coronary artery bypass grafting.

 Young Chul Yoo  ;  Young-Nam Youn  ;  Jae Kwang Shim  ;  Jong Chan Kim  ;  Na Young Kim  ;  Young Lan Kwak 
 CIRCULATION JOURNAL, Vol.74(9) : 1852-1858, 2010 
Journal Title
Issue Date
Acute Kidney Injury/drug therapy* ; Aged ; Angiotensin Receptor Antagonists/therapeutic use ; Angiotensin-Converting Enzyme Inhibitors/therapeutic use ; Coronary Artery Bypass, Off-Pump/adverse effects* ; Creatine/blood ; Data Collection ; Female ; Humans ; Incidence ; Logistic Models ; Male ; Middle Aged ; Renin-Angiotensin System/drug effects* ; Retrospective Studies
Acute kidney injury ; Off-pump coronary artery bypass grafting ; Renin-angiotensin system inhibitors
BACKGROUND: Despite several studies that evaluated the effects of renin-angiotensin system (RAS) inhibitors on postoperative renal function in cardiac surgery patients, no final conclusions are available. The aim of the present study was to determine the effect of RAS inhibitors on renal function following off-pump coronary artery bypass grafting (OPCAB). METHODS AND RESULTS: Among patients who underwent OPCAB, perioperative characteristics, postoperative renal function and incidence of acute kidney injury (AKI) were compared between those who received RAS inhibitors for at least 2 weeks (RASI group, n=296) and those not treated with RAS inhibitors (Control group, n=176). AKI was defined as an increase in serum creatinine >0.3 mg/dl or >50% from baseline. Preoperative comorbidities were more frequent in the RASI group. Operative data were similar. Incidence of postoperative AKI (19.9% vs 20.9%, P=0.815) and of postoperative renal function was comparable between groups. In the adjusted multivariate logistic regression model for propensity scores between groups, diabetes mellitus, preoperative creatinine level and perioperative transfusion were significant risk factors for postoperative AKI, whereas preoperative treatment with RAS inhibitors did not increase the risk. CONCLUSIONS: Chronic preoperative use of RAS inhibitors did not affect postoperative renal function or increase the risk of postoperative AKI in patients undergoing OPCAB
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1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Thoracic and Cardiovascular Surgery (흉부외과학교실) > 1. Journal Papers
Yonsei Authors
Kwak, Young Lan(곽영란) ORCID logo https://orcid.org/0000-0002-2984-9927
Kim, Jong Chan(김종찬)
Shim, Jae Kwang(심재광) ORCID logo https://orcid.org/0000-0001-9093-9692
Yoo, Young Chul(유영철) ORCID logo https://orcid.org/0000-0002-6334-7541
Youn, Young Nam(윤영남)
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