Abstract
Between March in 1987 and July in 1994, estracorporeal ultrafiltration method (ECUM) and or hemodialysis (HD) during cardiopulmonary bypass (CPB) was applied dueto preoperative renal failure in 18 patients (valvular disease in 8 and ishcemie heart desease in 5, vascular disease in 3, valvular disease associatedd with ishcemic heart disease in 2). They were divided into the following three groups according to thier preoperative renal function: Group I (6 patients), the level of creatinine (Cr)≤3.0mg/dl; Group II (5 patients), 3.1≤Cr≤5.0mg/dl, Group III (7 patients, including preoperative HD in 6), Cr≥5.1mg/dl. The operation was performed with CPB under moderate hypothermia and HD and/or ECUM was installed parallel to the CPB. The results as follows: 1) The more preoperative renal function impaired, the more postoperative renal damage prolonged. 2) The postoperative dialysis for renal dy sfunction was not requiredin the patients with a preoperative Cr level less than 5.0mg/dl. It seemed to be quite effective for cardiovascular operation of patients with severe renal dysfunction to use ECUM and HD during CPB because perioherative elevation of the ler ets of serum BUN, Cr, and potassium was less than that in patients with ECUM alone.
