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Published on: September 15, 2023
Renal failure after coronary bypass surgery and the associated risk factors
Hasan Reyhanoglu1, Kaan Ozcan1, Murat Erturk1
1Department of Cardiovascular Surgery, Private Tınaztepe Hospital, İzmir.
Insights
Diabetes and vasopressor use are key risk factors for acute kidney injury after coronary artery bypass grafting (CABG). Hemodialysis-dependent renal failure increases mortality significantly.
Area of Science:
- Cardiology
- Nephrology
- Surgical Outcomes
Background:
- Coronary artery bypass grafting (CABG) is a common cardiac procedure.
- Acute kidney injury (AKI) is a significant postoperative complication following CABG.
- Identifying risk factors for AKI post-CABG is crucial for patient management.
Purpose of the Study:
- To evaluate risk factors associated with acute renal failure (ARF) in patients undergoing CABG.
- To identify predictors of hemodialysis-dependent ARF after CABG.
Main Methods:
- A comparative study involving 106 patients with ARF post-CABG (RF group) and 110 controls without ARF (C group).
- The RF group was further divided into those treated conservatively (NH group) and those requiring hemodialysis (HR group).
- Multivariate analysis was used to identify significant risk factors.
Main Results:
- Diabetes mellitus, positive inotropes, and adrenaline were significant risk factors for ARF post-CABG.
- Carotid stenosis and postoperative adrenaline use predicted hemodialysis-dependent ARF.
- Mortality was 13.2% in the ARF group, with 6.2% in the NH group and 34% in the HR group.
Conclusions:
- Renal failure requiring hemodialysis post-CABG is associated with high morbidity and mortality.
- Diabetes mellitus, carotid artery stenosis, and vasopressor use are major risk factors for ARF.
- Management strategies should focus on these risk factors to improve outcomes.
Objective:
We aimed to evaluate the risk factors associated with acute renal failure in patients who underwent coronary artery bypass surgery.
Methods:
One hundred and six patients who developed renal failure after coronary artery bypass grafting (CABG) constituted the study group (RF group), while 110 patients who did not develop renal failure served as a control group (C group). In addition, the RF group was divided into two subgroups: patients that were treated with conservative methods without the need for hemodialysis (NH group) and patients that required hemodialysis (HR group). Risk factors associated with renal failure were investigated.
Results:
Among the 106 patients that developed renal failure (RF), 80 patients were treated with conservative methods without any need for hemodialysis (NH group); while 26 patients required hemodialysis in the postoperative period (HR group). The multivariate analysis showed that diabetes mellitus and the postoperative use of positive inotropes and adrenaline were significant risk factors associated with development of renal failure. In addition, carotid stenosis and postoperative use of adrenaline were found to be significant risk factors associated with hemodialysis-dependent renal failure (P < .05). The mortality in the RF group was determined as 13.2%, while the mortality rate in patients who did not require hemodialysis and those who required hemodialysis was 6.2% and 34%, respectively.
Conclusions:
Renal failure requiring hemodialysis after CABG often results in high morbidity and mortality. Factors affecting microcirculation and atherosclerosis, like diabetes mellitus, carotid artery stenosis, and postoperative vasopressor use remain the major risk factors for the development of renal failure.
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