Renal function and outcome from coronary artery bypass grafting: impact on mortality after a 2.3-year follow-up

Area of Science:

• Nephrology
• Cardiology
• Surgical Outcomes

Background:

• Severe kidney dysfunction worsens outcomes after coronary artery bypass graft surgery (CABG).
• Previous studies used serum creatinine, an insensitive marker of kidney function.
• Estimated glomerular filtration rate (eGFR) may be a more accurate measure for predicting outcomes.

Purpose of the Study:

• To evaluate the utility of eGFR in predicting mortality after CABG.
• To determine if eGFR is a better predictor than traditional risk scores.

Main Methods:

• Studied 2067 patients undergoing CABG.
• Calculated eGFR using the Modification of Diet in Renal Disease equation.
• Followed patients for a median of 2.3 years to assess all-cause mortality.

Main Results:

• Mean eGFR was lower in patients who died (57.9 mL/min/1.73 m2) compared to survivors (64.7 mL/min/1.73 m2).
• eGFR was an independent predictor of mortality (HR 0.71 per 10 mL/min/1.73 m2, P<0.001).
• eGFR remained a significant predictor even when included in risk models (HR 0.80, P<0.001; HR 0.88, P=0.02).

Conclusions:

• Estimated glomerular filtration rate (eGFR) is a powerful predictor of mortality after CABG.
• eGFR provides valuable prognostic information beyond traditional risk factors.