APROTININ FOR CORONARY-ARTERY BYPASS-GRAFTING - EFFECT ON POSTOPERATIVE RENAL-FUNCTION

Two hundred sixteen patients undergoing coronary artery bypass graft p rocedures were randomized to receive either high-dose aprotinin or pla cebo. Clinically important postoperative renal insufficiency was infre quent, with a single patient (0.9%) from each group requiring dialysis . Although increases in the serum creatinine level occurred postoperat ively in more patients who received aprotinin (20/108) than in those g iven placebo (13/108), the difference between the two groups was not s tatistically significant (p = 0.186), and the increases were generally small and transient. Likewise, there was no difference between the gr oups in terms of the incidence of abnormal serum electrolyte levels, b lood urea nitrogen levels, or urinalysis findings, or in the frequency of abnormal creatinine clearance rates. Under the conditions describe d, aprotinin use does not appear to be associated with a significant r isk of serious renal toxicity.