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Outcome of renal insufficiency patients undergoing coronary artery bypass graft surgery

Amala P Chirumamilla1, Michael F Wilson, Gregory E Wilding

  • 1University at Buffalo, State University of New York, Buffalo, NY, USA. amaladr@gmail.com

Cardiology
|February 2, 2008
PubMed

Insights

Renal insufficiency (RI) impacts cardiovascular disease outcomes. Coronary artery bypass graft (CABG) surgery shows acceptable results for patients with mild to severe RI when perioperative risks are minimized.

Area of Science:

  • Cardiology
  • Nephrology
  • Surgical Outcomes

Background:

  • Renal insufficiency (RI) is a recognized prognostic marker in patients with cardiovascular disease.
  • Accurate assessment of renal function is crucial for managing patients undergoing major cardiac procedures.

Purpose of the Study:

  • To evaluate the outcomes of coronary artery bypass graft (CABG) surgery in patients with varying degrees of renal insufficiency.
  • To determine if the Modification of Diet in Renal Disease (MDRD) study equation impacts the assessment of CABG outcomes.

Main Methods:

  • A cohort of 1,055 patients undergoing CABG between 2000-2005 were categorized into National Kidney Foundation (NKF) stages based on GFR calculated by the MDRD equation.
  • Specific perioperative precautions were implemented for patients with RI, including avoiding hypotension and fluid overload, and minimizing cardiopulmonary bypass time.

Main Results:

  • Thirty-day mortality was low (0.48%) and not statistically different across NKF stages 1-4.
  • While bleeding requiring reoperation and total complications increased from stages 1 to 4, these increases were not statistically significant.
  • Preoperative renal dysfunction was identified as a significant predictor of outcomes in CABG patients.

Conclusions:

  • CABG surgery can yield acceptable results for patients with varying degrees of renal insufficiency.
  • Minimizing perioperative risk factors is essential for achieving favorable outcomes and avoiding increased complications or mortality in these patients.

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