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Mortality risk factors in chronic renal failure patients after coronary artery bypass grafting

Beril Akman1, Ayse Bilgic, Gulsah Sasak

  • 1Department of Nephrology, Baskent University Faculty of Medicine, Ankara, Turkey. dr.berilakman@gmail.com

Renal Failure
|November 13, 2007
PubMed

Insights

This study on coronary artery bypass grafting (CABG) in chronic renal failure (CRF) patients found that while hemodialysis dependency didn't significantly increase mortality, infections were a major risk factor for death and prolonged hospitalization.

Area of Science:

  • Cardiology
  • Nephrology
  • Surgical Outcomes

Background:

  • Coronary artery bypass grafting (CABG) poses high perioperative risks for patients with chronic renal disease (CRF).
  • Understanding mortality risk factors in CRF patients undergoing CABG, particularly those dependent on hemodialysis (HD), is crucial.

Purpose of the Study:

  • To determine two-year postoperative mortality rates in CRF patients undergoing CABG.
  • To identify preoperative, operative, and postoperative risk factors associated with mortality in both hemodialysis-dependent and non-dependent CRF patients.

Main Methods:

  • Retrospective analysis of 102 CRF patients (47 HD-dependent, 55 non-dependent) who underwent CABG between 2000-2005.
  • Data collected included demographics, clinical, operative, echocardiographic, and biochemical parameters.
  • Cox regression analysis was used to identify significant risk factors for mortality.

Main Results:

  • Two-year mortality rates were 27.7% in the HD-dependent group and 16.4% in the non-dependent group (p > .05).
  • Age was a significant preoperative predictor of survival in HD-dependent patients (RR = 1.06, p = .04).
  • Infectious complications, including mediastinitis, were major determinants of mortality in both groups (RR = 4.42 for HD-dependent, RR = 9.39 for non-dependent).

Conclusions:

  • Hemodialysis dependency did not significantly increase mortality in CABG patients when younger and electively prepared.
  • High rates of infectious complications significantly increase postoperative mortality and hospitalization duration in CRF patients.
  • Early diagnosis and management of infections are critical for improving outcomes in CRF patients post-CABG.

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