Renal Disease Is Associated With Poor Outcomes Following Isolated Coronary Artery Bypass Grafting

Area of Science:

• Cardiology
• Nephrology
• Public Health

Background:

• Patients with renal disease exhibit elevated risks for cardiovascular disease and adverse outcomes post-cardiac surgery.
• Limited data exists on post-operative outcomes after isolated coronary artery bypass graft (CABG) in Australian patients with renal disease.

Purpose of the Study:

• To investigate the impact of varying stages of renal disease on post-operative mortality and complications in Australian patients undergoing isolated CABG.
• To analyze the association between renal disease severity and both short-term and long-term adverse outcomes.

Main Methods:

• Utilized data from 44,968 patients who underwent isolated CABG between 2001 and 2014 from the Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) registry.
• Employed multivariable logistic regression for short-term outcomes and Cox's regression for long-term outcomes to assess the effect of renal disease stages.

Main Results:

• 74.6% of patients had some degree of renal disease (mild, moderate, severe, or dialysis-dependent).
• Adjusted 30-day mortality risk increased significantly with renal disease severity, from 1.6-fold for mild to 4.6-fold for dialysis-dependent.
• Worsening renal disease correlated with higher post-operative complication rates and increased long-term mortality risk (1.1-fold for mild to 3.9-fold for dialysis-dependent).

Conclusions:

• Pre-existing renal disease is a significant independent predictor of increased 30-day and long-term mortality following isolated CABG.
• Renal disease severity is associated with longer intensive care unit and hospital stays, and a higher incidence of post-operative complications.