The association of ε-aminocaproic acid with postoperative decrease in creatinine clearance in 1502 coronary bypass patients

Mark Stafford-Smith, Barbara Phillips-Bute, Donal N. Reddan, J. Black, Mark F. Newman

Research output: Contribution to journalArticlepeer-review

32 Scopus citations

Abstract

Renal dysfunction is a common serious complication after cardiac surgery. Reports of proteinuria and hyperkalemia after cardiac surgery with ε-aminocaproic acid (EACA) have therefore raised concerns for renal safety. Since EACA renders these markers unreliable, we used perioperative change in creatinine clearance (DCrCl) to test the hypothesis that EACA is associated with greater reductions in creatinine clearance after heart surgery, particularly for patients with renal disease. We evaluated data from all elective primary coronary bypass patients during EACA introduction at our institution (July 1, 1991-December 31, 1992; 10 g iv bolus precardiopulmonary bypass, then 1 g/h for 5 h). DCrCl was calculated using preoperative (CrPre) and postoperative peak serum creatinine values, using the Cockroft-Gault equation. Patients with CrPre ≥ 133 μmol/L were also separately analyzed. Evaluated patients (n = 1502, ±EACA; 581/905, 16 exclusions) included 233 with CrPre ≥ 133 μmol/L (±EACA; 98/135). Multivariate analyses confirmed several known risk factors, but no association between DCrCl and EACA in all patients (P = 0.66), and the subgroup with CrPre ≥ 133 μmol/L (P = 0.42).

Original languageEnglish
Pages (from-to)1085-1090
Number of pages6
JournalAnesthesia and Analgesia
Volume91
Issue number5
DOIs
StatePublished - 2000

Bibliographical note

Funding Information:
This study was supported by the Cardiothoracic Division, Department of Anesthesiology, Duke University Medical Center, Durham, NC.

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

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