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Coronary surgery in patients requiring chronic hemodialysis

T Krabatsch1, R Yeter, R Hetzer

  • 1Deutsches Herzzentrum Berlin, Klinik fur Herz-, Thorax- und Gefasschirurgie, Berlin, Deutschland, Germany. krabatsch@dhzb.de

Kidney & Blood Pressure Research
|March 15, 2006
PubMed

Insights

Coronary artery bypass grafting (CABG) in chronic dialysis patients has a 5.6% perioperative mortality. Mid-term survival is acceptable when tailored care is provided for this unique patient group.

Area of Science:

  • Cardiovascular Surgery
  • Nephrology
  • Critical Care Medicine

Background:

  • Coronary artery bypass grafting (CABG) in patients with chronic kidney disease on hemodialysis presents unique perioperative challenges.
  • Uremic patients often have comorbidities, including peripheral artery disease and anemia, complicating surgical management.

Purpose of the Study:

  • To evaluate the outcomes of CABG in patients requiring chronic hemodialysis.
  • To compare the results with a matched control group of non-uremic patients undergoing CABG.

Main Methods:

  • Retrospective analysis of 71 chronic dialysis patients who underwent CABG between 2001 and 2004.
  • Comparison with a randomized control group of 68 non-uremic patients who underwent CABG during the same period.

Main Results:

  • The incidence of CABG among chronic dialysis patients was 1.12% (71 out of 6315).
  • Perioperative mortality in the dialysis group was 5.6%.
  • One-year survival was 87.7% for uremic patients vs. 91.0% for controls; 4-year survival was 56.7% vs. 88.0%, respectively. Dialysis patients had higher rates of peripheral artery disease, lower hemoglobin, and required more transfusions.

Conclusions:

  • Coronary artery bypass grafting can be performed in uremic patients with acceptable mid-term survival rates.
  • Careful consideration of the specific needs of dialysis patients is crucial for successful perioperative management and improved outcomes.
Abstract

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