Key result
Dialysis dependence shows no significant difference in post-CABG mortality compared to non-dialysis status.
Why the study?
Renal dysfunction is a predictor of increased morbidity and mortality after CABG, but outcomes in chronic renal failure patients with or without dialysis dependence needed further evaluation.
What are the postoperative outcomes and complication rates in patients with chronic renal failure undergoing CABG?
Cohort (n=76)
No
What are the postoperative outcomes and complication rates in patients with chronic renal failure undergoing CABG?
Absolute Event Rate: 5.6% vs 15%
Chronic renal failure, regardless of dialysis dependence, is associated with high in-hospital mortality and morbidity following CABG, with a significant risk of requiring postoperative dialysis in non-dialysis patients.
Renal dysfunction signals higher CABG risk; retrospective data leaves open whether current perioperative care modifies outcomes in this population.
INTRODUCTION: Renal failure predisposes patients to adverse outcome after coronary artery bypass grafting (CABG). Renal dysfunction is a predictor of increased morbidity and mortality after CABG, whether it is dialysis-dependent or not. METHODS: In a retrospective study from April 2000 to December 2010, seventy-six patients (60 male and 16 female with the mean age of 58.57±7.93 years) with different categories of chronic renal failure undergoing CABG in Shahid Madani Hospital, were studied. The cardiac disease leading to the operation was coronary artery disease (CAD) in all patients. Patients demographic, surgical and laboratory data were gathered from hospital records. Data were then analyzed. RESULTS: Mean hospital stay was 10.16±7.16 days. The preoperative mortality rate was 10.5% (15% in non dialysis and 5.6% in dialysis dependant patients with no significant difference). Morbidity rate was 28.9% (respectively 30% and 27.8% in dialysis and non dialysis patients with no significant difference) including in-hospital myocardial infarction (MI) (10.5%), in-hospital stroke (2.6%), in-hospital bleeding (21.1%) and in-hospital infection, pneumonia, (5.3%). Mean creatinine and blood urea nitrogen (BUN) levels were significantly increased after surgery (p<0.001). Postoperative hemodialysis rate was 33.3%. CONCLUSION: Chronic renal failure whether dialysis-dependant or not increases in-hospital mortality and morbidity in patients undergoing CABG. For CRF patients not on dialysis with a creatinine 2.5 gm/dL, there is a strong likelihood of postoperative dialysis.
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Safaie et al. (2011) conducted a cohort in Chronic renal failure and coronary artery disease (n=76). Dialysis-dependent chronic renal failure vs. Non-dialysis chronic renal failure was evaluated on Mortality. Dialysis-dependent chronic renal failure was associated with a 5.6% mortality rate compared to 15% in non-dialysis patients undergoing CABG, with no significant difference between groups.
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