Diuretic Effect of Aminophylline and Furosemide in Adult Patients Undergoing Cardiac Surgical Procedures

Acute Kidney injury (AKI) is a serious and common complication after either adult or pediatric cardiac surgery.

The results of a recent meta-analysis suggested that loop diuretics (furosemide) may reduce postoperative creatinine clearance, whereas aldosterone agonists (spironolactone) increase the incidence of cardiac surgery-associated acute kidney injury (CSA-AKI). Diuretics are not recommended for the prevention of AKI, but loop diuretics may be used for the management of volume overload Aminophylline in cardiac surgery can reduce the frequency of AKI and could be used in the prevention of AKI as a safe and efficient modality in high-risk patients.

Inclusion criteria

• Age from 18-65 years.
• Both sexes.
• All adult patients presenting for elective cardiac surgical procedures performed on cardiopulmonary bypass (Coronary artery bypass surgery, Cardiac valve repair and/or replacement, Repair of large septal defects, Repair and/or palliation of congenital heart defects, Transplantation, surgery of thoracic aneurysms.).
• Body mass index (BMI) ranged between 20 and 40 kg/m2.

Exclusion criteria

• Sensitivity or contraindication to Aminophylline or furosemide
• Stage-5 chronic kidney disease (CKD) [Glomerular filtration rate (GFR) of less than 15 mL/min].
• The presence of both factors (GFR less than 60 mL/min and albumin greater than 30 mg per gram of creatinine) along with abnormalities of kidney structure or function for greater than three months signifies chronic kidney disease.
• Recipients of dialysis before surgery.
• Recipients of solid-organ transplantation before surgery.
• Emergency cardiac surgical procedures (e.g. left main coronary artery bypass graft, stuck valves, etc).
• Patient refusal.