透析に依存しない腎不全患者の冠動脈バイパス移植
1Division of Cardiovascular Surgery, Sunnybrook Health Science Centre and The Toronto Hospital, Ontario, Canada.
Circulation
|December 31, 1997
まとめ
軽度の腎不全で冠動脈バイパス移植 (CABG) 手術を受ける患者は,より高いリスクに直面します. これには,血液輸血の必要性が増加し,低出力症候群,および透析に依存することなくとも,より長い入院期間が含まれます.
科学分野:
- 心臓病学 心臓病学
- ネフロロジーはネフロロジーを用います.
- 外科手術の結果について
背景:
- 術前腎不全は,冠動脈バイパス移植 (CABG) 手術に関連する罹病率と死亡率のリスクを大幅に高めます.
- 軽度の非透析依存性腎不全の患者に対するCABGの影響は,大部分が特徴づけられていない.
研究 の 目的:
- この状態のない対照群と比較して,軽度の手術前の腎不全を有する患者の単離CABGのアウトカムを調査する.
主な方法:
- 術前腎不全 (血清クレアチニン>150マイクロモル/L) 患者38人のコホートは,CABG患者2978人 (1990年-1996年) から同定された.
- これらの患者は,6つの予後変数に基づいて152人の対照患者とマッチングされました.
- 術前透析を必要とする患者は分析から除外された.
主要な成果:
- 腎不全グループでは,高齢化,糖尿病,高血圧,外周血管疾患,左心室機能不全の罹患率が高かった.
- 腎不全の患者は,手術前後の輸血 (P<.001) と手術後の透析 (P<.01) を必要とする可能性が高くなりました.
- より長い換気時間,集中治療室 (ICU) の滞在,手術後の入院は,腎不全のグループで観察されました. 軽度の腎不全は,手術後の低出力症候群 (OR=3.6) を独立して予測した.
結論:
- 透析状態に関係なく,軽度の腎不全は,CABG中にリスクの増加と関連しています.
- これらのリスクには,輸血の可能性が高まり,低出力症候群の発生,ICUの延長,手術後の入院などが含まれる.
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