Cardiopulmonary Bypass and its Impact on Post-Operative Renal Function in Patients Undergoing Adult Cardiac Surgery

Abstract

Objective: This study aims to investigate the impact of cardiopulmonary bypass (CPB) on post-operative renal function in patients undergoing adult cardiac surgery. Specifically, it seeks to assess the incidence of acute kidney injury (AKI) and renal dysfunction in relation to the duration of CPB and other perioperative factors. Study design and setting: It was a retrospective observational cross-sectional study and conducted at department of adult cardiac surgery in Peshawar Institute of Cardiology. Methodology: A retrospective observational study was conducted, including adult patients who underwent cardiac surgery with CPB from 1-June-2024 to 1-December-2024. Patient data were collected from electronic medical records, including demographic information, comorbidities, intraoperative variables (e.g., CPB time, temperature management), and post operative renal function markers (serum creatinine, urine output). Results: A total of 150 patients were included in the study. The incidence of AKI was found to be significantly higher in patients with hypertension, elevated pre-op urea and creatine and prolonged Cross clamp times (p < 0.05), particularly those with CPB durations exceeding 120 minutes. Other factors such as pre-existing renal comorbidities, intraoperative blood loss, and use of nephrotoxic drugs also contributed to an increased risk of post-operative renal dysfunction. Conclusion: In conclusion, the results of this study support the notion that CPB and cardiac surgery can lead to renal dysfunction, as evidenced by the significant rise in creatinine and urea levels. However, the lack of significant change in urine volume and the improvement in cardiac function as reflected by LVEF suggest that patient management strategies, including appropriate fluid balance and renal monitoring, may mitigate some of the renal complications.