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Assessment of Vascular Function in Patients With Chronic Kidney Disease
08:50

Assessment of Vascular Function in Patients With Chronic Kidney Disease

Published on: June 16, 2014

Coronary artery bypass surgery in patients on chronic hemodialysis. A case-control study

E Deutsch1, R C Bernstein, P Addonizio

  • 1Hospital of the University of Pennsylvania, Philadelphia.

Annals of Internal Medicine
|March 1, 1989
PubMed

Insights

Patients on chronic hemodialysis undergoing coronary artery bypass surgery experience increased morbidity. However, bypass surgery remains an acceptable treatment for advanced coronary artery disease in this population.

Area of Science:

  • Cardiology
  • Nephrology
  • Surgical Outcomes

Background:

  • Patients with end-stage renal disease often have complex cardiovascular conditions.
  • Coronary artery bypass surgery (CABG) in patients on chronic hemodialysis presents unique challenges.
  • Assessing the risks and benefits of CABG in this high-risk group is crucial.

Purpose of the Study:

  • To evaluate the morbidity and mortality associated with cardiac catheterization and CABG in patients undergoing chronic hemodialysis.
  • To compare outcomes in hemodialysis patients with matched control groups.

Main Methods:

  • Retrospective case-control study design.
  • Inclusion of 16 patients on chronic hemodialysis who underwent cardiac catheterization and CABG.
  • Comparison with 30 case-matched controls and 34 consecutive controls.

Main Results:

  • No major complications from cardiac catheterization were observed.
  • Hemodialysis patients showed significantly increased postoperative morbidity, including longer mechanical ventilation, hemodynamic support, ICU stay, and overall hospital stay.
  • Mortality was low, with one death in the hemodialysis group versus none in the matched controls.

Conclusions:

  • Coronary artery bypass surgery is an acceptable treatment for hemodialysis patients with advanced coronary artery disease.
  • Increased morbidity in hemodialysis patients necessitates careful perioperative management.
  • Earlier evaluation for revascularization may improve outcomes, especially given the frequent need for urgent surgery.
Abstract

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