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Ann Thorac Surg 1995;59:132-136
© 1995 The Society of Thoracic Surgeons

Aprotinin for Coronary Artery Bypass Grafting: Effect on Postoperative Renal Function

John H. Lemmer, Jr, MD, William Stanford, MD, Sharon L. Bonney, MD, Eva V. Chomka, MD, Robert B. Karp, MD, Glenn W. Laub, MD, John A. Rumberger, PhD, MD, Hartzell V. Schaff, MD

Departments of Surgery and Radiology, The University of Iowa College of Medicine, Iowa City, Iowa, and Miles Inc, West Haven, Connecticut, and Department of Medicine, University of Illinois at Chicago, Chicago, Illinois, and Department of Surgery, Deborah Heart and Lung Center, Brown Mills, New Jersey, and Departments of Radiology and Surgery, The University of Chicago, Chicago, Illinois, and Department of Cardiovascular Diseases and Section of Cardiovascular Surgery, Mayo Clinic, Rochester, Minnesota

Accepted for publication July 16, 1994.

Two hundred sixteen patients undergoing coronary artery bypass graft procedures were randomized to receive either high-dose aprotinin or placebo. Clinically important postoperative renal insufficiency was infrequent, with a single patient (0.9%) from each group requiring dialysis. Although increases in the serum creatinine level occurred postoperatively in more patients who received aprotinin (20/108) than in those given placebo (13/108), the difference between the two groups was not statistically significant (p = 0.186), and the increases were generally small and transient. Likewise, there was no difference between the groups in terms of the incidence of abnormal serum electrolyte levels, blood urea nitrogen levels, or urinalysis findings, or in the frequency of abnormal creatinine clearance rates. Under the conditions described, aprotinin use does not appear to be associated with a significant risk of serious renal toxicity.




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