J.Jpn. Surg. Soc.
ISSN 1880-1129

[Abstract] [Full Text PDF] （in Japanese / 1901KB） [Members Only And Two Factor Auth.]

J.Jpn. Surg. Soc.. 85(5): 415-420, 1984

Original article

TUBULAR DYSFUNCTION AFTER OPEN HEART SURGERY

Second Department of Surgery, School of Medicine, Nagoya University, Nagoya, Japan
*) Tajimi Prefectural Hospital, Tajimi, Japan
**) Okazaki City Hospital, Okazaki, Japan

Fumihiko Yasuma, Kenzo Yasuura, Hirosi Okamoto, Masaharu Miyazaki, Sigeru Hirose, Jun Akune, Tatuhei Kondo, Yutaka Ogawa*), Akira Seki**)

β2-microglobulin(BMG) and conventional renal function parameters (creatinine clearance (C-cr) etc.) were measured in 36 adult patients before and after open heart surgery (Group-2). Same study was performed in 14 adult patients abdominal surgery (Group-1).
Urinary BMG concentration (U-BMG) increased remarkably in both groups immediately after surgery. U-BMG returned to the preoperative level on the 4th postoperative day (4-POD) in Group-1, and 7-POD in Group-2. The degree of increase in Group-2 was remarkable comparing with that in Group-1. The tubular dysfunction after surgery was believed to result in a marked rise in U-BMG, therefore, the later recovery and higher increase of U-BMG in Group-2 indicated that the tubular dysfunction after open heart surgery was severer comparing with that after abdominal surgery.
On 7-POD, in Group-2, U-BMG was still abnormal in 13 cases, which suggested the prolonged tubular dysfunction after open heart surgery. A retrospective study to determine the risk factors of prolonged tubular dysfunction was performed in 34 patients in Group-2. Significant risk factors were preoperative blood urea nitrogen and urine osmolarity. Several factors were not significant including perfusion time, aortic alamp time, preoperative C-cr, U-BMG, serum creatinine concentration and free water clearance.

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