Effects Of Ultrafiltration On Renal Function During Cardiopulmonary Bypass

Objective To investigate the effects of ultrafiltration on renal function after cardiopulmonary bypass (CPB).Methods Fourty congenital heart diseases(CHD) patients (24 male, 16 female) aged from 2m-6yr, weighed 5-15kg underwent open heard surgery with CPB were randomly divided into two grouos: group ultrafiltration (group U, n=20) and group control (group C, n=20 ). In group U, ultrafiltration was performed during warming period and after cardiopulmonary bypass when the hemodynamic was stable. Ultrafiltration was not performed in group C. Blood samples were taken and urine was collected before operation, before ultrafiltration or CPB was stopped, on the 1st, 3 rd, 5 th after operation for determination of serum urea nitrogen(BUN),creatinine(Cr), and urinary retinal binding protein(RBP) , microalbumin(MA) , transferrin(TRU), immunoglobulin(IgG) and α 1-Microglobulin(AlM).Results (1)There were no significant differences between the two groups with respect to age, sex, body weight, CPB time and aortic cross-clamping time, priming, urine during CPB, MAP during CPB, 24hour urine after operation. But the real priming in group C was significantly higher than that was in group U(p<0.01). (2)BUN and Cr levels increased significantly on the 1st day after operation(p<0.01) in both groups. BUN was remain increased significantly on the 3rd day after operation (p<0.05) in group C. BUN and Cr were significantly higher in group C than those in group U on the 1st (P<0.01) and 3rd day after operation (P<0.01). (3)The urinary RBP concentration increased significantly on the 1st (P<0.01) and 3rd day after operation (P<0.05) as compared with the baseline values in group C and increased significantly on the 1st day after operation (P<0.05) in group U. There were no significant differences between the two groups at the corresponding time points(p>0.05). (4) The urinary MA increased significantly before ultrafiltration or CPB was stopped > on the 1st (PO.Ol).. 3rd (P<0.01)and 5 th day after operation (P<0.01) as compared with the baseline values in two groups. The MA was significantly higher in group C than that was in group U on the 1st (P<0.01), 3rd (P<0.05). (5) The urinary TRU increased significantly on the 1st day...