Authors : Xiaolin Wang, Lei Chen, Junjie Yang, Fei Hua, Yunsheng Yu, Yanqiu Hu, Wenxue Ye, Haoyue Huang, Yihuan Chen, Hong Nin, Qingwei Ding and Zhenya Shen
Abstract: To evaluate the impact of Histidine-Tryptophan-Ketoglutarate solution (HTK solution, Koehler Chemie, Germany) for coronary perfusion in cardiopulmonary bypass on the risk of post-operative Acute Renal Failure (ARF) requiring Renal Replacement Therapy (RRT). The data of patients aged over 18 were retrospectively analyzed for the Cardiopulmonary Bypasses (CPB) performed in our Heart Center from April 2012 to October 2013. According to Simplified Renal Index (SRI) Scoring System, the patients were divided into two groups: the experiment group (using HTK solution and the control group (using cold blood cardioplegia solution). The actual occurrence rate of RRT for the postoperative ARF was analyzed for both groups. Furthermore, the pre and post-operative Glomerular Filtration Rate (GFR) were also compared between the two groups. According to SRI Scoring System, 512 patients were selected: 239 cases in the experiment group and 273 cases in the control group. The probability of RRT for post-operative ARF was 0.42% in the experiment group and was 4.03% in the control group (p<0.05). Comparing the experiment group and the control group with a score of ≥3 (48 cases in the experiment group and 44 cases in the control group), the occurrence rate in the control group (22.73%) was significant higher than that in the experiment group (2.08%). The pre and post-operative GFR levels in patients with a score of ≥3 were continuously monitored. No obvious statistical difference (p>0.05) was observed pre-operation (HTK: 72.6±32.93; cold blood: 72.73±29.31), on the 1st post-operative day (HTK: 62.38±26.76; cold blood: 58.89±23.22) and at the discharge day (HTK: 86.40±19.99; cold blood: 81.51±33.95). However, the GFR level of HTK solution group was significantly higher than that of cold blood group on the second (HTK: 73.13±26.01; cold blood: 61.10±23.40; p<0.05) and the 3rd post-operative days (HTK: 84.99±25.07; cold blood: 69.62±32.50; p<0.05). The SRI Scoring System was able to distinguish the low or high risk patients before cardiac surgery. For patients with an SRI score of ≥3 using the HTK solution for coronary perfusion could effectively reduce the risk of RRT for post-operative ARF and protect renal function.
Xiaolin Wang, Lei Chen, Junjie Yang, Fei Hua, Yunsheng Yu, Yanqiu Hu, Wenxue Ye, Haoyue Huang, Yihuan Chen, Hong Nin, Qingwei Ding and Zhenya Shen, 2013. Use of Histidine-Tryptophan-Ketoglutarate Solution for Coronary Perfusion in Cardiopulmonary Bypass Can Reduce the Risk of Renal Replacement Therapy for Post-Operative Acute Renal Failure. Journal of Animal and Veterinary Advances, 12: 1095-1100.