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Implications of Hemodialysis in Patients Undergoing Coronary Artery Bypass Grafting

Jimmy T Efird1, Wesley T O'Neal2, Catherine A Gouge2

  • 1Department of Cardiovascular Sciences, East Carolina Heart Institute, 115 Heart Drive, Greenville, NC 27834, USA ; Center for Health Disparity Research, East Carolina University, USA.

International Journal of Cardiovascular Research
|October 14, 2014
PubMed

Insights

Patients on hemodialysis undergoing coronary artery bypass grafting (CABG) have significantly shorter long-term survival compared to those not on dialysis. This highlights a critical need for further research into cost and policy implications for these patient groups.

Area of Science:

  • Nephrology
  • Cardiology
  • Outcomes Research

Background:

  • Cardiovascular disease is a primary cause of death in hemodialysis patients.
  • Limited data exists on long-term outcomes post-coronary artery bypass grafting (CABG) in diverse, underserved populations.

Purpose of the Study:

  • To compare the long-term survival of hemodialysis patients with non-hemodialysis patients after isolated coronary artery bypass grafting (CABG).

Main Methods:

  • A comparative survival analysis was performed on hemodialysis versus non-hemodialysis patients undergoing non-emergent, isolated CABG.
  • Kaplan-Meier survival probabilities and Cox regression models were utilized to assess survival outcomes.
  • Hazard ratios (HR) and 95% confidence intervals (95%CI) were calculated.

Main Results:

  • Hemodialysis patients (n=220) exhibited substantially shorter long-term survival (median 3.3 years) compared to non-hemodialysis patients (median 14 years; p<0.0001).
  • This survival disparity remained statistically significant after adjusting for relevant clinical factors (HR=5.2, 95%CI=4.4-6.2).

Conclusions:

  • Hemodialysis patients experience significantly reduced long-term survival following CABG compared to their non-hemodialysis counterparts.
  • Further investigation into the economic and policy aspects of these findings is crucial, particularly for vulnerable patient populations.
Abstract

Keywords:
CABGHemodialysisSurvival

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