EA Retrospective Evaluation of Renal Function Parameter Changes in Patients Undergoing Open-Heart Surgery

Öz

Background: This study aimed to evaluate perioperative changes in renal function in patients undergoing open-heart surgery over the past one and a half years and to identify factors associated with an increased risk of postoperative acute kidney injury. 

Materials and Methods: Between January 2024 and September 2025, adult patients without a history of chronic kidney disease who underwent open-heart surgery at Harran University Faculty of Medicine were retrospectively evaluated. Preoperative and postoperative inflammation parameters, renal function tests, and urine output were analyzed using appropriate statistical methods. 

Results: A total of 197 adult patients were included in the study and divided into two groups: Group I (AVR/MVR, n=40) and Group II (CABG, n=157). The groups were comparable in terms of sex, age, and body mass index (p>0.05). No significant within-group changes were observed in preoperative and postoperative uric acid, serum creatinine, blood urea nitrogen, and estimated glomerular filtration rate values (p>0.05). However, postoperative urine output and C-reactive protein levels showed significant increases (p=0.001). Between-group comparisons revealed that only uric acid levels were significantly different in both the preoperative (p=0.031) and postoperative (p=0.024) periods. Total bypass time was significantly associated only with preoperative C-reactive protein levels (p=0.008).

Conclusions: In adults undergoing elective open-heart surgery, cardiopulmonary bypass (CPB) duration does not appear to have a significant short-term effect on renal function. However, the association between preoperative inflammation levels and CPB duration, as well as perioperative risk, suggests that the inflammatory status may influence the surgical course and the likelihood of complications.

Anahtar Kelimeler

• Cardiopulmonary Bypass
• Renal function
• Acute kidney injury
• Cardiac surgery

Retrospektif Bir Değerlendirme: Açık Kalp Cerrahisi Uygulanan Hastalarda Renal Fonksiyon Parametrelerindeki Değişiklikler

Öz

Amaç: Bu çalışma, son bir buçuk yıl içerisinde açık kalp cerrahisi geçiren hastalarda perioperatif böbrek fonksiyonlarındaki değişiklikleri değerlendirmeyi ve postoperatif akut böbrek hasarı gelişme riskini artıran faktörleri belirlemeyi amaçlamaktadır.

Materyal ve metod: Ocak 2024 - Eylül 2025 arasında Harran Üniversitesi Tıp Fakültesi’nde açık kalp cerrahisi yapılan, kronik böbrek yetmezliği öyküsü olmayan hastaların pre- ve postoperatif inflamasyon parametreleri, böbrek fonksiyon testleri ve idrar çıkışı retrospektif olarak incelenmiş ve istatistiksel olarak analiz edilmiştir.

Bulgular: Çalışmaya dahil edilen 197 erişkin hasta iki gruba ayrıldı: Grup I (AVR/MVR, n=40) ve Grup II (CABG, n=157). Gruplar cinsiyet, yaş ve beden kitle indeksi açısından benzerdi (p>0,05). Preoperatif ve postoperatif dönemde ürik asit, serum kreatinin, üre ve tahmini glomerüler filtrasyon hızı değerlerinde grup içi anlamlı değişiklik saptanmadı (p>0,05). Ancak postoperatif dönemde idrar miktarı ve c-reaktif protein düzeylerinde anlamlı artış gözlendi (p=0,001). Gruplar arası karşılaştırmada yalnızca ürik asit düzeyleri preoperatif (p=0,031) ve postoperatif (p=0,024) dönemde anlamlı farklılık gösterdi. Total bypass süresi ile yalnızca preoperatif c-reaktif protein düzeyleri arasında anlamlı ilişki saptandı (p=0,008).

Sonuç: Elektif açık kalp cerrahisi uygulanan erişkinlerde, kardiyopulmoner bypass (KPB) süresinin kısa dönemde böbrek fonksiyonları üzerinde anlamlı bir etkisi gözlenmemektedir. Bununla birlikte, preoperatif inflamasyon düzeyinin (c-reaktif protein) KPB süresi ve perioperatif risk ile ilişkili olması, inflamatuar durumun cerrahi süreci ve komplikasyon olasılığını etkileyebileceğini düşündürmektedir.

Anahtar Kelimeler

• Kardiyopulmoner Bypass
• Böbrek fonksiyonları
• Akut böbrek hasarı
• Kardiyak cerrahi

Kaynakça

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