Risk of Acute Kidney Injury after Off-Pump Coronary Artery Bypass Grafting in Patients with Poor Glycemic Control

Introduction: Coronary artery bypass grafting (CABG) is a commonly performed procedure in ischemic heart disease (IHD) patients. Acute kidney injury (AKI) is a frequent complication of CABG. Many patients undergoing surgery have Diabetes Mellitus, which increases risk of AKI after CABG. Limited work has been done to see the impact of poor glycemic control on incidence of AKI after off-pump CABG. However, local data on the subject was missing especially using OFF PUMP technique. Aims & Objectives: Aim of this study was to find effects of poor glycemic control on acute kidney injury after Off- pump CABG. Place and Duration of Study: The study was carried out at the Department of Cardiothoracic Surgery, Shaikh Zayed Hospital, Lahore from 1st October 2021 to 30th September 2022. Material & Methods: 130 diabetic patients were divided into two equal groups of 65, exposed to poor glycemic control (HbA1c ? 6.5%) and unexposed with good glycemic control (HbA1c < 6.5%). Postoperative variables like urine output, serum creatinine levels and e-GFR were recorded for 72 hours. Mean ± SD were computed for quantitative variables and frequency (%) was computed for qualitative variables using SPSS 24.0.0: Risk ratio >1 was considered as significant. Results: In the unexposed group, 58 individuals (89.2%) did not experience AKI after 72 hours, while 7 individuals (10.8%) did. Conversely, exposed, 48 individuals (73.8%) did not experience AKI in the exposed group, while 17 individuals (26.2%) did. Relative risk calculated was 2.35(CI: 1.12- 7.70), p=0.01. Conclusion: Poor glycemic control has increased risk for developing AKI, increased serum creatinine levels and eGFR after off-pump-CABG compared to patients with good glycemic control.