Related Experiment Video
Updated: May 20, 2026
A Large Animal Model for Acute Kidney Injury by Temporary Bilateral Renal Artery Occlusion
Published on: February 2, 2021
Outcome of coronary artery bypass grafting in end stage renal disease patients
Keng-Hee Koh1, Clare Tan, Lawrence Hii
1Nephrology Unit, Hospital Umum Sarawak. kohkenghee@yahoo.com
Insights
Coronary artery bypass grafting (CABG) in end-stage renal disease (ESRD) patients shows acceptable perioperative complications and comparable ICU/hospital stays to non-ESRD patients. Long-term survival for ESRD patients undergoing CABG is similar to those not receiving CABG.
Area of Science:
- Cardiology
- Nephrology
- Surgical Outcomes
Background:
- End-stage renal disease (ESRD) patients exhibit significantly higher rates of cardiac disease and mortality compared to the general population.
- Revascularization procedures like coronary artery bypass grafting (CABG) may present increased risks in ESRD patients.
- This study aimed to compare outcomes of CABG in ESRD patients against both non-ESRD patients and ESRD patients not undergoing CABG.
Purpose of the Study:
- To evaluate the peri-operative complications associated with CABG in ESRD patients.
- To compare ICU and hospital stay durations for ESRD patients undergoing CABG versus non-ESRD patients.
- To assess the long-term survival rates of ESRD patients after CABG compared to ESRD patients without CABG.
Main Methods:
- An observational study included ESRD patients who underwent CABG between 2003-2009.
- Case-control matching was used to compare with non-ESRD patients for resource utilization (ICU/hospital stay).
- Survival analysis compared ESRD patients with CABG against a matched cohort of ESRD patients without CABG; patients with valvular surgery were excluded.
Main Results:
- Eleven ESRD patients (mean age 57.5, mostly diabetics) underwent CABG. One experienced hemorrhage, four had transient post-operative hypotension.
- ICU stay (3.1 vs 3.2 days) and hospital stay (7.6 vs 6.9 days) were comparable between ESRD and non-ESRD patients.
- Over a mean follow-up of 3.3 years, long-term survival for ESRD patients with CABG was similar to matched ESRD patients without CABG (e.g., 5-year survival 40.0% vs 40.3%).
Conclusions:
- CABG in ESRD patients is associated with an acceptable rate of peri-operative complications.
- ESRD patients undergoing CABG demonstrate comparable ICU and hospitalization durations to their non-ESRD counterparts.
- Long-term survival outcomes for ESRD patients after CABG are at least as favorable as those for matched ESRD patients who did not undergo CABG.
Introduction:
End stage renal disease (ESRD) patients have a much higher rate of cardiac disease and cardiac mortality as compared with the general population. Revascularisation such as coronary artery bypass grafting (CABG) may also carry a higher rate of complications and morbidity. We compared our ESRD patients who underwent CABG with the general population and ESRD population.
Methods:
This is an observational study of ESRD patients who underwent CABG in our centre from 2003-2009 with case-control matching comparison with non-ESRD patients for ICU and hospital stay; and ESRD patients without CABG for survival. Patients with concomitant valvular operation were excluded. The primary outcomes were peri-operative complications and survival.
Results:
Eleven patients with mean age of 57.5 +/- 8.5 were included. All except 1 were diabetics. One patient had excessive haemorrhage requiring immediate re-thoracotomy, and this was complicated with thrombosed AVF. Four patients experienced intradialytic hypotension postoperatively but all resolved within 1 week. Both ESRD and non-ESRD patients had equal number of ICU stay (3.1 versus 3.2 days, p = 0.906) and hospital stay (7.6 versus 6.9 days, p = 0.538). With average of 3.3 years follow-up (range from 1 to 7 years), 4 deaths were observed but only one from cardiac cause. Both ESRD cohorts with or without CABG have compatible left ventricular mass: 295 +/- 86 vs 343 +/- 113 g (p=0.226) and left ventricular mass: 174 +/- 54 vs. 206 +/- 63 g/m2 (p = 0.157). The outcome of CABG ESRD patients was comparable to matched ESRD patients without CABG with 90.9 % versus 91.9% 1 year survival, 95.5% versus 77.7% 2 year survival, 71.4% versus 70.3% 3 year and 40.0% versus 40.3% at 5 year survival (p = 0.627, 0.386, 0.659 and 0.683 respectively).
Conclusion:
CABG in ESRD patients carries an acceptable perioperative complication rate. They have acceptable ICU and hospitalization duration in comparison to non-ESRD patients. Their long term survival was at least as good as matched ESRD patients without CABG.
Related Concept Videos
01:28Kidney Transplant I: Introduction
01:26Kidney Transplant II: Surgical Procedure
01:29Acute Kidney Injury III: Clinical Manifestations
01:16Kidney Transplant III: Nursing Management
01:28Chronic Kidney Disease III: Interprofessional Care
01:26Heart Failure Drugs: Inhibitors of Renin-Angiotensin System