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Long-term outcome of patients who require renal replacement therapy after cardiac surgery

G Landoni1, A Zangrillo, A Franco

  • 1Università Vita-Salute di Milano, IRCCS San Raffaele Hospital, Department of Cardiovascular Anaesthesia and Intensive Care, Italy. landoni.giovanni@hsr.it

European Journal of Anaesthesiology
|January 5, 2006
PubMed

Insights

Patients needing renal replacement therapy after cardiac surgery face high in-hospital mortality. However, survivors experience good long-term survival and quality of life, indicating a manageable outcome post-discharge.

Area of Science:

  • Nephrology
  • Cardiology
  • Critical Care Medicine

Background:

  • Acute renal failure is a significant complication following cardiac surgery.
  • Patients requiring renal replacement therapy (RRT) after cardiac surgery represent a substantial burden on healthcare resources.
  • The long-term outcomes for these patients have been inadequately evaluated.

Purpose of the Study:

  • To evaluate the long-term survival and quality of life in patients who required renal replacement therapy post-cardiac surgery.
  • To identify predictors of the need for renal replacement therapy after cardiac surgery.

Main Methods:

  • A cohort of 7846 cardiac surgery patients was analyzed.
  • 126 patients (1.6%) required postoperative renal replacement therapy.
  • Multivariate analysis identified predictors of RRT; long-term survival and quality of life were assessed in RRT patients and matched controls.

Main Results:

  • In-hospital mortality was significantly higher in the RRT group (66.7%) compared to the control group (1.5%).
  • Predictors for RRT included preoperative renal dysfunction, diabetes, hypertension, congestive heart failure, ejection fraction <40%, and emergency surgery.
  • Independent predictors of RRT were identified as urine output <1000 mL, chronic obstructive pulmonary disease, and age.

Conclusions:

  • In-hospital mortality for patients requiring renal replacement therapy after cardiac surgery remains high.
  • Patients who survive hospitalization and are discharged alive demonstrate favorable long-term survival rates.
  • A reasonable quality of life can be achieved by patients who survive the initial perioperative period and are discharged.
Abstract

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