Diltiazem treatment does not alter renal function after thoracic surgery

Background: There are conflicting reports on the effects of diltiazem treat ment on renal function in surgical patients. We sought to determine whether diltiazem treatment alters renal function in patients undergoing major tho racic surgery. Methods: In a prospective study, 330 patients scheduled for elective thorac ic surgery received either FV diltiazem (n = 167) or placebo (n = 163) imme diately after the operation and orally thereafter for 14 days in an effort to prevent postoperative atrial arrhythmias, Serum creatinine and BUN level s were compared before and during the first postoperative week. Results: Patients treated with diltiazem were similar to control subjects i n terms of age (mean +/- SD, 66 +/- 10 years vs 67 +/- 10 years, respective ly), baseline serum creatinine or BUN levels, prevalence of comorbid condit ions, and surgical characteristics. During the first 5 postoperative days, the two groups did not differ in terms of serum creatinine or BUN levels. T he incidence of renal failure was 0.6% in the diltiazem group and 1.2% in t he placebo group (difference was not significant). There was no difference in the length of hospitalization or mortality rate. Conclusions: In patients without renal disease who are undergoing elective thoracic surgery, prophylactic diltiazem treatment did not alter postoperat ive renal function.