Related Experiment Video

Updated: Aug 27, 2026

Evaluation of Coronary Flow Reserve After Myocardial Ischemia Reperfusion in Rats
06:32

Evaluation of Coronary Flow Reserve After Myocardial Ischemia Reperfusion in Rats

Published on: June 28, 2019

Outcome of coronary revascularization in patients on renal dialysis

M Agirbasli1, W S Weintraub, G L Chang

  • 1Andreas Gruentzig Cardiovascular Center, Division of Cardiology, Emory University School of Medicine, Atlanta, Georgia, USA.

The American Journal of Cardiology
|August 18, 2000
PubMed

Insights

Percutaneous transluminal coronary angioplasty (PTCA) and coronary artery bypass grafting (CABG) show similar high 1-year mortality in renal dialysis patients. Focus should shift to preventing and treating coronary artery disease before revascularization.

Area of Science:

  • Cardiology
  • Nephrology
  • Interventional Cardiology

Background:

  • Retrospective studies indicate high mortality and poor outcomes for renal dialysis patients undergoing percutaneous transluminal coronary angioplasty (PTCA) or coronary artery bypass grafting (CABG).
  • Renal dialysis patients represent a high-risk population for cardiovascular interventions.

Purpose of the Study:

  • To compare mortality and clinical event rates between PTCA and CABG in patients on renal dialysis.
  • To evaluate the safety and efficacy of coronary revascularization strategies in this specific patient cohort.

Main Methods:

  • A retrospective analysis of 252 renal dialysis patients who underwent PTCA (122) or CABG (130) between 1987 and 1997.
  • Comparison of baseline characteristics, angiographic findings, in-hospital outcomes, and 1-year mortality between the PTCA and CABG groups.

Main Results:

  • The CABG group had a higher prevalence of left main and 3-vessel coronary artery disease.
  • Periprocedure and in-hospital mortality were significantly higher in the CABG group (6.9%) compared to the PTCA group (1.6%).
  • One-year mortality rates were similar (23% PTCA vs. 27% CABG), with PTCA patients requiring repeat revascularization more frequently (22% vs. 2%).

Conclusions:

  • Both PTCA and CABG can be performed in selected renal dialysis patients with acceptable in-hospital complication rates.
  • One-year mortality remains high for dialysis patients following coronary revascularization, underscoring the need for preventative strategies.
  • Future efforts should prioritize the prevention and early treatment of coronary artery disease in renal dialysis patients to improve long-term outcomes.

More Related Videos

A Modified Two Kidney One Clip Mouse Model of Renin Regulation in Renal Artery Stenosis08:21

A Modified Two Kidney One Clip Mouse Model of Renin Regulation in Renal Artery Stenosis

Published on: October 26, 2020

Improved Renal Denervation Mitigated Hypertension Induced by Angiotensin II Infusion08:35

Improved Renal Denervation Mitigated Hypertension Induced by Angiotensin II Infusion

Published on: May 26, 2022

Related Concept Videos

Renal Drug Excretion: Overview01:15

Renal Drug Excretion: Overview

As primary excretory organs, the kidneys maintain homeostasis by removing waste substances from the bloodstream. They comprise over a million units called nephrons, which serve as the kidney's functional units.
A nephron consists of two primary structures: the renal corpuscle and the renal tubule. The renal corpuscle contains the glomerulus, a network of capillaries where the first step of renal excretion, glomerular filtration, occurs. Blood pressure forces water, ions, and small molecules out...
Renal Failure: Dose Adjustments01:11

Renal Failure: Dose Adjustments

In patients with renal impairment, drugs undergo significant changes in their pharmacokinetics, which require dosage adjustments to ensure safe and effective therapy.
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...
Coronary Artery Disease V: Interprofessional Care01:27

Coronary Artery Disease V: Interprofessional Care

Interprofessional care for coronary artery disease includes pharmacological therapy and revascularization procedures.Pharmacological therapy for Coronary Artery Disease (CAD) aims to manage symptoms, prevent complications, and improve patient outcomes through various classes of medications:Antiplatelet Agents:Aspirin and Clopidogrel: These medications inhibit platelet aggregation, preventing blood clots, which is crucial for avoiding heart attacks and strokes. Doctors often prescribe these...
Continuous Renal Replacement Therapy01:30

Continuous Renal Replacement Therapy

Continuous Renal Replacement Therapy, also known as CRRT, is a procedural treatment for acute kidney injury (AKI) that gradually removes uremic toxins and fluids while maintaining acid-base balance and stabilizing electrolytes. It is particularly useful for hemodynamically unstable patients. Unlike intermittent hemodialysis, which is faster, CRRT provides a gentler approach over 24 hours, closely mimicking the function of natural kidneys. However, CRRT is not ideal for patients with...
Hemodialysis II: Procedure and Complications01:24

Hemodialysis II: Procedure and Complications

DialyzersA hemodialysis (HD) dialyzer is a plastic cartridge containing thousands of parallel hollow fibers, which serve as semipermeable membranes. These fibers are typically made from cellulose-based or other synthetic materials. During HD, blood is pumped into the top of the cartridge and distributed among these fibers. Simultaneously, dialysis fluid, known as dialysate, is introduced into the bottom of the cartridge, bathing the outside of the fibers. Across the semipermeable membrane,...
Acute Kidney Injury IV: Diagnostic Studies and Prevention01:30

Acute Kidney Injury IV: Diagnostic Studies and Prevention

Accurate diagnosis and effective prevention are critical in managing Acute Kidney Injury (AKI), which is linked to high mortality rates ranging from 10% to 80%. Timely recognition of at-risk patients and careful monitoring can significantly reduce the likelihood of kidney damage.Diagnostic Assessments:The diagnostic process starts with a comprehensive medical history to identify prerenal, intrarenal, and postrenal causes.Prerenal causes, such as dehydration, hypotension, or blood loss, should...