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Characteristics of Hemodialysis Patients and Renal Transplant Recipients Undergoing Cardiovascular Intervention: Is
Dilek Aslan Kutsal1, Fatih Kizilyel2, Rafet Gunay3
1Department of Nephrology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey.
Insights
Heart surgery is safe for renal transplant recipients and hemodialysis patients. Managing cardiovascular risk factors is key for better outcomes in these high-risk populations.
Area of Science:
- Nephrology
- Cardiology
- Transplantation
Background:
- Cardiovascular disease is a leading cause of death in renal transplant and hemodialysis patients.
- This study focuses on the risks and outcomes of heart surgery in these specific patient groups.
Purpose of the Study:
- To evaluate preoperative risk factors for cardiovascular surgery in renal transplant recipients and hemodialysis patients.
- To assess postoperative outcomes in these patient cohorts.
Main Methods:
- Retrospective analysis of 83 patients (47 renal transplant, 36 hemodialysis) undergoing cardiac procedures.
- Data collected included demographics, cardiac surgery type, and preoperative lab findings from electronic records.
Main Results:
- No significant differences in age, sex, or comorbidities between renal transplant recipients and hemodialysis patients.
- Both groups showed high rates of metabolic issues (elevated glucose, triglycerides, LDL) indicating insulin resistance.
- Low glomerular filtration rate and hemoglobin < 10 g/dL increased acute kidney injury risk in transplant recipients, leading to graft loss in 4 patients.
Conclusions:
- Cardiovascular surgery is feasible and safe for both renal transplant recipients and end-stage kidney disease patients on hemodialysis.
- Proactive identification and management of cardiovascular risk factors are crucial for improving surgical outcomes.
Introduction:
Cardiovascular problems are one of the major causes of morbidity and mortality among renal transplant and hemodialysis patients. This study evaluates the preoperative risk factors and postoperative outcomes in patients undergoing heart surgery.
Methods:
A total of 83 patients (47 post-renal transplant recipients and 36 on hemodialysis) who underwent cardiac surgery and percutaneous coronary artery procedures at Dr. Siyami Ersek Heart Hospital between 2015 and 2022 were retrospectively analyzed using hospital electronic records without selection bias. Demographic information, such as age, sex, height, weight, and body mass index, cardiac surgery type, and preoperative laboratory findings were recorded.
Results:
Renal transplant recipients and hemodialysis patients undergoing heart surgery showed no significant differences in age, sex, or comorbidities (P > 0.05). Both groups had a high percentage of patients with elevated fasting blood glucose, triglycerides, and low-density lipoprotein levels. Additionally, body mass index and the triglyceride-glucose index were elevated, indicating insulin resistance. Renal transplant recipients with low preoperative glomerular filtration rate and hemoglobin levels < 10 g/dL had a higher risk of developing acute kidney injury. Four patients (9%) experienced graft loss after acute kidney injury, requiring hemodialysis. Mortality rates did not differ significantly between the groups (P > 0.56).
Conclusion:
Cardiovascular surgery can be safely performed in both renal transplant recipients with functional allografts and end-stage kidney disease patients on hemodialysis. Identifying and managing risk factors in these patients, who frequently experience cardiovascular complications, will lead to better outcomes.
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