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Perfusion
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Renal effects of cardiopulmonary bypass in the elderly

Marius G Dehne

Department of Anesthesiology and Intensive Care Medicine, Justus-Liebig-University Giessen, Giessen, Germany, marius.g.dehne{at}chiru.med.uni-giessen.de

Armin Sablotzki

Clinic of Anesthesiology and Intensive Care Medicine, Martin-Luther-University Halle/Wittenberg, Wittenberg, Germany

Jörg Mühling

Department of Anesthesiology and Intensive Care Medicine, Justus-Liebig-University Giessen, Giessen, Germany

Karl-Lorenz Dehne

UNAIDS, Vienna, Austria

Rainer Röhrig

Department of Anesthesiology and Intensive Care Medicine, Justus-Liebig-University Giessen, Giessen, Germany

Gunter Hempelmann

Department of Anesthesiology and Intensive Care Medicine, Justus-Liebig-University Giessen, Giessen, Germany

Cardiopulmonary bypass is widely believed to be injurious to renal function. The unknown consequences of renal dysfunction with modern techniques of bypass in the elderly caused us to examine creatinine clearance and the excretion of sensitive marker proteins in older adult patients undergoing CABG. Thirty male patients were divided into three groups: group I with an age up to 60 years, group II with an age between 61 and 70 years, inclusive and group III 71 years and over. Serum creatinine and urea, creatinine clearance, and {alpha}1-micro-globulin ({alpha}1-MG), N-acetyl-ß-D-glucosaminidase (NAG), Tamm -Horsfall protein (TH) and immunoglobulin G (IgG) were all measured daily, pre- and postoperatively. Creatinine clearance remained lower in the older patients without significant differences. Raised excretion rates of {alpha}1-MG, and IgG were seen after CPB. The increase in {alpha}1- MG and NAG during the postoperative period revealed tubular damage in all elderly patients. Measurements of {alpha}1-MG, NAG and IgG represent useful supplements to standard clinical tests for recognizing early and differentiated changes in renal function.

Perfusion, Vol. 17, No. 3, 205-209 (2002)
DOI: 10.1191/0267659102pf571oa
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