Key result
Off-pump CABG fails to reduce AKI or mortality over on-pump surgery in CKD patients.
Why the study?
Postoperative outcomes of various CABG options in patients with chronic kidney disease, including off-pump versus on-pump and combined valve interventions, remain unclear.
Does off-pump CABG or avoiding combined surgical interventions reduce the risk of postoperative complications, acute kidney failure, and mortality in patients with chronic kidney disease?
Cohort (n=168)
Does off-pump CABG or avoiding combined surgical interventions reduce the risk of postoperative complications, acute kidney failure, and mortality in patients with chronic kidney disease?
In patients with chronic kidney disease, off-pump CABG does not offer a significant advantage over on-pump CABG in preventing acute kidney injury or mortality, and combined procedures carry substantial risks.
Objective. To evaluate postoperative outcomes of various coronary artery bypass grafting (CABG) options in patients with chronic kidney disease (CKD): with and without cardiopulmonary bypass (CPB), combination with valve interventions. Material and methods. A retrospective analysis included 168 patients who underwent surgery between 2017 and 2024. Early postoperative complications, incidence of acute kidney failure (AKF), hospital-stay and mortality were compared depending on intervention. Results. The highest rate of complications, including dialysis-dependent acute kidney injury (AKI), was observed after combined surgical interventions (CABG+heart valve surgery). Off-pump CABG does not demonstrate any advantage in reducing the risk of AKI or mortality compared to on-pump CPB. The main risk factors of AKF were older age, male gender, reduced ejection fraction, diabetes mellitus and extent of surgery. Conclusion. CABG method in patients with CKD should take into account anatomical features of coronary arteries and severity of renal dysfunction. Despite potential advantages of off-pump CABG, its effectiveness in patients with CKD remains controversial and requires further research.
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Владимирович et al. (2026) conducted a cohort in Chronic kidney disease requiring coronary artery bypass grafting (n=168). Coronary artery bypass grafting options (off-pump vs on-pump vs combined CABG+valve) vs. Comparison between different surgical interventions was evaluated on Early postoperative complications, incidence of acute kidney failure, hospital-stay and mortality. Off-pump CABG did not reduce the risk of AKI or mortality compared to on-pump CPB, while combined CABG and heart valve surgery had the highest rate of complications in patients with CKD.
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