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The relationship between renal function and outcome from heart valve surgery

Patrick H Gibson1, Bernard L Croal, Brian H Cuthbertson

  • 1Department of Cardiology, University of Aberdeen and Aberdeen Royal Infirmary, Aberdeen, UK.

American Heart Journal
|December 9, 2008
PubMed

Insights

Renal function is a key predictor of survival after heart valve surgery. Lower estimated glomerular filtration rate (eGFR) independently indicates a higher risk of death, even when considering other risk factors.

Area of Science:

  • Cardiology
  • Nephrology
  • Surgical Outcomes

Background:

  • Prognostic significance of renal function in valvular heart disease surgery is unclear.
  • This study investigates renal function as a predictor of outcomes in cardiac surgery patients.

Purpose of the Study:

  • To determine the prognostic value of renal function, specifically estimated glomerular filtration rate (eGFR), in patients undergoing heart valve surgery.
  • To assess if eGFR independently predicts mortality beyond established risk scores like EuroSCORE.

Main Methods:

  • Prospective data collection from 514 patients undergoing heart valve surgery (excluding endocarditis/emergency cases).
  • Estimated glomerular filtration rate (eGFR) calculated using the Modification of Diet in Renal Disease equation.
  • All-cause mortality as the primary outcome, with follow-up for a median of 2 years.

Main Results:

  • 87 deaths occurred during follow-up.
  • Both eGFR and creatinine levels predicted mortality in univariable analysis.
  • eGFR remained a significant independent predictor of death in multivariable models, including EuroSCORE.
  • Preoperative eGFR <60 mL/min/1.73 m2 was associated with significantly increased hazard of death (HR 2.31, P=.001).

Conclusions:

  • Estimated glomerular filtration rate (eGFR) is a potent, independent predictor of outcomes in patients undergoing heart valve surgery.
  • The prognostic value of eGFR is significant, irrespective of other known risk factors and the EuroSCORE.
  • Assessing renal function is crucial for risk stratification in patients undergoing cardiac valve procedures.
Abstract

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