RENAL AND HEMODYNAMIC-EFFECTS OF DILTIAZEM AFTER ELECTIVE MAJOR VASCULAR-SURGERY - A POTENTIAL RENOPROTECTIVE AGENT

A postoperative study was done of the effects of an infusion of diltia zem (DTZ), 1 mu g . kg(-1) . min(-1) after a bolus dose of 0.28 mg . k g(-1) on renal function and hemodynamics in 10 patients who were opera ted with insertion of an abdominal aortic graft. Urine flow, glomerula r filtration rate (GFR) by inulin clearance, and renal plasma flow (RP F) by PAH clearance and fractional excretion of electrolytes and osmol s were measured for three periods of 20 min during infusion of DTZ, in the morning after surgery Systemic hemodynamic studies were conducted and serum levels of catecholamines were measured. GFR increased durin g the initial period of DTZ infusion. There were no significant change s during the study period in any of the other parameters, compared to baseline, except for a decrease in heart rate from 84 to 77 beats per minute. The absence of a sustained increase in GFR and a natriuretic a nd diuretic effect may possibly be ascribed to a preexisting nonconstr icted status of the renal vasculature. The authors conclude that the d ose of DTZ used in this study can be safely used for further investiga tions to elucidate the effects of peroperative infusion of DTZ as rena l function in connection with major vascular surgery.