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Abstract
Renal dysfunction of variable severity is not uncommon after CABG surgery, ranging from mild, sub-clinical disorders, up to acute renal failure. The overall incidence of postoperative renal dysfunction is 11%. In patients with PRD, the mortality rate is 12.4% compared with 0.4% in non PRD patients. The importance of perioperative renal protection originates from the high mortality of ARF (60-90%) even with the aggressive utilization of dialysis.
Calcium channel blockers produce renal vasodilation and increase in RBF and GFR. Free radical formation and interference with mesangial acromolecular entrapment have been reduced by using calcium antagonists. Furthermore, calcium antagonists enhance sodium and water excretion, and reduce aldosterone secretion. In addition, calcium antagonists have been associated with cytoprotective effects in acute renal failure by inhibition of increased intracellular calcium load related to an ischemic renal insult.
Diltiazem is a calcium channel blocker from the benzothiazepines group that block L-type voltage gated calcium channels, that produces renal vasodilation and increases in RBF and GFR.
This study was done to evaluate the effect of diltiazem infusion as a method for renal protection in patients undergoing CABG surgery.