RESEARCH ARTICLE SA JOURNAL OF DIABETES & VASCULAR DISEASE 26 VOLUME 20 NUMBER 2 • NOVEMBER 2023 The incidence of AKI in the entire patient group was found to be 29%, according to the AKIN criteria. When comparing the patients who developed AKI in the two groups, 21 patients in group 1 and six patients in group 2 developed AKI. This difference was not statistically significant (p = 0.081) (Fig. 2). The correlation of cross-clamp times and total perfusion times with creatinine change was also examined in the study. In the DM group (group 1), a negative correlation was found between the postoperative creatinine increase on day 5 and the total perfusion time (R = –0.294, p = 0.023). The length of stay in the ICU was significantly longer in the DM group than in the non-DM group (p = 0.031). No patient required ultrafiltration in the peri-operative period. With the exception of erythrocyte suspension, no blood product was used in any of the patients in the pre-, intra- or postoperative period. The amount of post-operative drainage and the use of erythrocyte suspension did not differ between the groups (Table 3). One patient in the DM group developed a saphenous vein infection and three in each group developed atrial fibrillation. These patients returned to sinus rhythm with amiodarone treatment. No in-hospital mortality was observed in the study. Discussion DM is a common disease worldwide and is among the leading causes of cardiovascular diseases. It increases the risk of coronary artery disease and heart failure, and these conditions themselves may increase the risk of kidney failure. In addition, independently of these, DM itself can cause kidney failure. DM is responsible for approximately half of all end-stage renal disease in the United States of America.10 Approximately half of coronary artery disease patients also have DM.11 One of the main treatment options for coronary artery disease is CABG surgery. It has been found that 30% of patients undergoing Fig. 1. Within-group serum creatinine levels. Fig. 2. Intergroup acute renal disease. ARD: acute renal disease, DM: diabetes mellitus. Table 2. Peri-operative data DM group (n = 60) Non-DM group (n = 33) Mean Median Mean Median Peri-operative data (SD) (min–max) (SD) (min–max) p-value* Cross-clamp time 76.97 72 65.12 59 0.41 (min) (22.09) (43–115) (16.38) (44–109) Total pump time 123 113 119 112 0.81 (min) (29.2) (80–175) (24.3) (80–175) Bypass numbers 4.5 4.00 4.01 4.00 0.91 (0.5) (2–5) (0.7) (2–5) SD: standard deviation, min: minumum, max: maximum, DM: diabetes mellitus. *Mann–Whitney U-test. Table 3. Pre- and postoperative data DM group (n = 60) Non-DM group (n = 33) Pre- and post- Mean Median Mean Median operative data (SD) (min–max) (SD) (min–max) p-value* Pre-operative 1.02 1.05 1.03 0.95 0.294* creatinine (mg/dl) (0.17) (0.70–1.34) (0.18) (0.70–1.34) Postoperative day 2 1.28 1.26 1.11 1.0 0.033** creatinine (mg/dl) (0.37) (0.49–2.3) (0.35) (0.62–1.93) Postoperative day 5 1.24 1.36 1.07 1.09 0.005* creatinine (mg/dl) (0.34) (0.69–1.63) (0.24) (0.69–1.63) Drainage amount 568.78 574.98 514.48 500.00 0.279* (ml) (198.33) (450–630) (155.00) (450–650) Erythrocytes used 3.3 3 3.12 3 0.897* (0.12) (2–5) (0.14) (2–5) Length of stay in 3.65 4 3.12 3 0.031* ICU (day) (1.16) (2–6) (0.96) (2–5) Length of stay in 8.50 8 8.48 8 0.960* hospital (day) (1.93) (6–12) (1.5) (6–12) DM: diabetes mellitus, min: minimum, max: maximum, ICU: intensive care unit, SD: standard deviation.*Mann–Whitney U-test, **t-test. Table 4. Within-group serum creatinine levels via pre- and postoperative 2nd and 5th days Pre-operative Postoperative Postoperative creatinine (mg/dl) day 2 creatinine day 5 creatinine (P1) (mg/dl) (P2) (mg/dl (P5) Mean Median Mean Median Mean Median Groups (SD) (min–max) (SD) (min–max) (SD) (min–max) DM 1.02 1.05 1.28 1.26 1.24 1.36 (0.17) (0.70–1.34) (0.37) (0.49–2.3) (0.34) (0.69–1.63) Non-DM 1.03 0.95 1.11 1.0 1.07 1.09 (0.18) (0.70–1.34) (0.35) (0.62–1.93) (0.24) (0.69–1.63) DM group: P2 > P1, p = 0.008, P5 > P1, p = 0.001.
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