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Coronary artery bypass grafting in patients with dialysis-dependent end stage renal disease: a prospective, nested

Kevin L Powell1, J Michael Smith, Scott E Woods

  • 1Department of Surgery, Good Samaritan Hospital, Cincinnati, Ohio 45220, USA.

Journal of Cardiac Surgery
|September 24, 2004
PubMed

Insights

Coronary artery bypass grafting (CABG) in patients with end-stage renal disease (ESRD) requiring dialysis does not increase perioperative risks. However, these patients experienced a longer hospital stay compared to those without ESRD.

Area of Science:

  • Cardiovascular Surgery
  • Nephrology
  • Critical Care Medicine

Background:

  • End-stage renal disease (ESRD) requiring dialysis is a significant comorbidity.
  • Coronary artery bypass grafting (CABG) is a common procedure for cardiovascular disease.

Purpose of the Study:

  • To compare intraoperative and postoperative morbidity and mortality in dialysis-dependent ESRD patients undergoing CABG versus patients without ESRD.

Main Methods:

  • Nested case-control study utilizing an 8-year prospective hospitalization cohort.
  • 28 dialysis-dependent ESRD patients (cases) matched 1:3 to 84 non-ESRD patients (controls) based on age, gender, tobacco history, and NYHA class.
  • Logistic regression analysis controlled for 13 potential confounding variables.

Main Results:

  • No significant differences in mortality, ICU length of stay, ventilator time, or specific complication rates (wound, pulmonary, neurological, GI, arrhythmia, intraoperative) were observed.
  • Dialysis-dependent ESRD patients had a significantly longer total hospitalization stay (21%) compared to controls.

Conclusions:

  • Dialysis-dependent ESRD does not elevate perioperative morbidity or mortality for CABG patients.
  • Increased length of hospitalization is a key outcome for ESRD patients undergoing CABG.
Abstract

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