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Evaluating the relative frequency and predicting factors of acute renal failure following coronary artery bypass
Mohsen Mirmohammad-Sadeghi1, Ali Naghiloo, Mohammad Reza Najarzadegan
1Assistant Professor, Cardiac Rehabilitation Research Center, Isfahan Cardiovascular Research Institute, Isfahan University of Medical ciences, Isfahan, Iran.
Insights
Older age and diabetes are significant risk factors for acute renal failure (ARF) after coronary artery bypass grafting (CABG). Early identification and management can improve outcomes for these high-risk patients.
Area of Science:
- Cardiology
- Nephrology
- Surgical Outcomes
Background:
- Acute renal failure (ARF) following coronary artery bypass grafting (CABG) significantly increases morbidity and mortality.
- Understanding ARF incidence and risk factors post-CABG is crucial for improving patient outcomes.
Purpose of the Study:
- To determine the incidence of ARF after CABG.
- To identify key risk factors associated with ARF in the post-CABG population.
Main Methods:
- A cross-sectional study involving 589 patients undergoing CABG between March 2010 and 2011.
- Patients were categorized into two groups based on ARF occurrence post-CABG.
- Statistical analysis compared variables between groups, with p < 0.05 considered significant.
Main Results:
- ARF occurred in approximately 22% of patients post-CABG.
- The ARF group was significantly older (mean age difference >3 years).
- Elevated serum creatinine, history of diabetes mellitus, and longer pump times were significantly associated with ARF.
Conclusions:
- Older patients and those with diabetes mellitus are at higher risk for ARF after CABG.
- While ARF is prevalent, severe cases requiring dialysis are infrequent (1.0-1.7%).
- Diabetic patients require careful consideration as a high-risk group for ARF post-cardiac surgery.
Background:
Renal dysfunction or acute renal failure in patients undergoing coronary artery bypass grafting (CABG) is an important cause of morbidity and mortality. The great impact of acute renal failure (ARF) in the outcomes of cardiac surgery demands its study in our population, encouraging to the elaboration of this study, which aimed to identify the incidence and risk factors of ARF after CABG.
Methods:
Since March 2010 to 2011, 589 patients were studied who underwent CABG in Sina Hospital (Isfahan, Iran). In this cross-sectional study, patients were divided into two groups based on the occurrence of ARF after CABG and measured variables were compared between the two groups was also statistically significant. P value less than 0.05 was set as a significant level.
Results:
A total of 434 men and 155 women were enrolled in the study. The mean age of the study subjects was 57.6 years. ARF was seen in about 22% of patients after CABG. The mean age of ARF group was more than 3 years higher than that in the other group and the difference was significant between the two groups. Serum creatinine level after the surgery was different between the two groups. Moreover, the history of diabetes mellitus was significantly different between the two groups. Pump time comparison also showed was also statistically significant.
Conclusion:
Our data showed older patients were more prone to affected by ARF. In addition, diabetic patients should be considered as high risk patients and are more likely to deteriorate by ARF. Despite increased prevalence of renal insufficiency in CABG patients, studies show that in most cases, this is not a serious problem and it is easily treatable. A lower proportion of patients (1.0 to 1.7% in different large series) develop ARF severe enough to require dialysis.
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