Renal Protective Effect of Nebivolol vs. Metoprolol in Diabetic Patients Undergoing Coronary Artery Bypass Surgery

Abstract

Introduction: This study aimed to determine whether pre-treatment with nebivolol provides better protection against postoperative renal injury than metoprolol in patients undergoing coronary artery bypass grafting. Patients and Methods: Sixty diabetic patients were divided into two groups as those receiving either nebivo lol (Group I, n= 30) or metoprolol (Group II, n= 30) treatment. The patients in Group I were initiated on ne bivolol 5 mg/day and those in Group II were initiated on metoprolol 50 mg/day. Postoperative renal functions were assessed by serial measurements of serum neutrophil gelatinase associated lipocalin (NGAL) and serum creatinine levels. P< 0.05 was considered as the level of statistical significance. Results: Demographic, preoperative clinical parameters and operative variables were similar between the two groups. The number of patients with two-hour NGAL positivity was not different between the two groups (7 [26.9%] vs. 7 [25.9%] p= 0.93). Only 1 patient from each group had higher creatinine values than the refer ence limit at 24 hours; whereas, 72-hour creatinine positivity was observed in 7 patients from each group. All patients achieved improvement with renal replacement therapy and hemodialysis requirement did not occur. Conclusion: Any difference between the use of metoprolol and nebivolol was not found in terms of better protection against early renal impairment in diabetic patients who underwent coronary artery bypass grafting.