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01.06.2018 | Original Article

Correction of dilutional anemia induces renal dysfunction in diabetic patients undergoing coronary artery bypass grafting: a consequence of microcirculatory alterations?

verfasst von: Güçlü Aykut, Meltem Kilercik, Cem Arıtürk, Halim Ulugöl, Uğur Aksu, Türkan Kudsioğlu, Nazan Atalan, Nihan Yapıcı, Hasan Karabulut, Fevzi Toraman

Erschienen in: Journal of Nephrology | Ausgabe 3/2018

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Abstract

Background

In this study we aimed to evaluate the effects of dilutional anemia resulting from cardiopulmonary bypass (CPB) and its correction with red blood cell (RBC) transfusion on tissue oxygenation and renal function in diabetic patients undergoing coronary artery bypass grafting (CABG).

Method

70 diabetic patients who underwent elective CABG and whose hematocrit values had been between 24–28% at any time during CBP were prospectively randomized and equally allocated to two groups: patients who received RBC during CPB (group I, n = 35) vs. did not receive RBC during CPB (group II, n = 35). Besides routine hemodynamic and biochemical parameters, biomarkers of ischemia and renal injury such as ischemia modified albumin (IMA), protein oxidation parameters [advanced oxidative protein products (AOPP), total thiol (T-SH)], neutrophil gelatinase-associated lipocalin (NGAL) and estimated glomerular filtration rate (eGFR) were measured in both groups.

Results

In group I, T-SH, NGAL and urea levels were found to be significantly increased postoperatively compared to preoperative measurements (p < 0.05). Also, postoperatively, NGAL, creatinine, aspartate aminotransferase and AOPP levels were higher in group I than group II (p < 0.05).

Conclusion

The correction of anemia with RBC transfusion in diabetic patients undergoing CABG could increase the risk of renal injury. Further studies verifying the effects of blood transfusions at the microcirculatory level are needed to optimize the efficacy of transfusions.

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Titel: Correction of dilutional anemia induces renal dysfunction in diabetic patients undergoing coronary artery bypass grafting: a consequence of microcirculatory alterations?
verfasst von: Güçlü Aykut
Meltem Kilercik
Cem Arıtürk
Halim Ulugöl
Uğur Aksu
Türkan Kudsioğlu
Nazan Atalan
Nihan Yapıcı
Hasan Karabulut
Fevzi Toraman
Publikationsdatum: 01.06.2018
Verlag: Springer International Publishing
Erschienen in: Journal of Nephrology / Ausgabe 3/2018
Print ISSN: 1121-8428
Elektronische ISSN: 1724-6059
DOI: https://doi.org/10.1007/s40620-017-0388-8

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Correction of dilutional anemia induces renal dysfunction in diabetic patients undergoing coronary artery bypass grafting: a consequence of microcirculatory alterations?