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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

16.5K

Coronary revascularisation in patients with chronic kidney disease and end-stage renal disease: A meta-analysis

Xihui Li1, Feng Xiao1, Siyu Zhang1

  • 1Department of Cardiac Surgery, Peking University First Hospital, Beijing, China.

International Journal of Clinical Practice
|June 12, 2021
PubMed

Insights

Coronary artery bypass grafting (CABG) offers lower long-term mortality for end-stage renal disease (ESRD) patients compared to percutaneous coronary intervention (PCI). However, CABG increases early mortality risk for both chronic kidney disease (CKD) and ESRD patients.

Area of Science:

  • Cardiovascular Medicine
  • Nephrology
  • Interventional Cardiology

Background:

  • Chronic kidney disease (CKD) and end-stage renal disease (ESRD) are associated with increased cardiovascular risk.
  • Optimal revascularization strategies for patients with CKD and ESRD remain debated.

Approach:

  • A meta-analysis of 31 observational studies involving 74,805 patients was conducted.
  • Studies compared coronary artery bypass grafting (CABG) with percutaneous coronary intervention (PCI) for revascularization in CKD and ESRD patients.

Key Points:

  • CABG was associated with higher early mortality in both CKD and ESRD patients compared to PCI.
  • For ESRD patients, CABG demonstrated significantly lower all-cause and cardiac mortality.
  • PCI was associated with a higher long-term risk of repeat revascularization and myocardial infarction in both CKD and ESRD patients.

Conclusions:

  • CABG may be a preferred strategy for long-term outcomes in ESRD patients, despite increased early mortality risk.
  • Further adequately powered, prospective randomized controlled trials (RCTs) are necessary to establish the optimal revascularization strategy for CKD and ESRD patients.
Abstract

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