Hypertonic siuretic infusion vs fractioned diuretic use for the acute renal failure following open heart surgery and the advantages of hemodiafiltration

Açık kalp cerrahisi sonrasında gelişen akut böbrek yetmezliğine hipertonik yetmezliğinde hipertonik diüretik kullanımının karşılaştırılması ve hemodiyafiltrasyonunun etkisi

Özet

Amaç: Bu çalışmayla açık kalp cerrahisi sonrası erken dönemde gelişen akut böbrek yetmezliğinde, hipertonik diüretik infüzyonu ile fraksiyone diüretik kullanımının etkinliğini karşılaştırmayı ve hemodiyafiltrasyonun etkinliğini araştırmayı planladık. Materyal ve Metod: Preoperatif renal fonksiyonları normal (kreatinin

Abstract

Bacground: We planned this study to compare the effectiveness of the hypertonic diuretic infusion and fractioned diuretic use in the acute renal failure (ARF) in the early period following open-heart surgery and to study the effects of the hemodiafiltration. Material and Methods: There were forty patients with impaired left ventricular function and normal preoperative renal function (creatinine < 1.5 mg/dl) who underwent open-heart surgery and developed ARF postoperatively. Hypertonic diuretic infusion was given to the first group whereas fractioned furosemide (500 mg/day) was applied to the second. Two patient groups were compared for weaning from oliguric/anuric ARF, hemodiafiltration and dialysis requirements. Results: Fourteen patients in the Group I (70%), and 10 patients (50%) in Group II were weaned from ARF in the 36-48th hours (mean 39±7 h.). Six patients in Group I (30%) and 10 patients (50%) in Group II required Conclusions: Hypertonic diuretic infusion use is more effective in diminishing the dialysis necessity for oliguric/anuric ARF following open-heart surgery compared to the fractioned diuretic use in the early period.