ISSN : 1301-5680
e-ISSN : 2149-8156
Turkish Journal of Thoracic and Cardiovascular Surgery     
Acute exacerbation in chronic kidney disease increases mortality after coronary artery bypass grafting
Deniz Göksedef1, Suat Nail Ömeroğlu1, Zeki Talas1, Ozan Onur Balkanay1, Nevzat Cem Sayılgan2, Gökhan İpek1
1Department of 1Cardiovascular Surgery, Medicine Faculty of Cerrahpaşa University, İstanbul
2Department of Anesthesiology, Medicine Faculty of Cerrahpaşa University, İstanbul
Background: In this article we investigated short term results of patients who had chronic kidney disease before coronary artery bypass graft (CABG) surgery.

Methods: The results of 360 patients who underwent elective CABG surgery between December 2006 and April 2008 were evaluated retrospectively. Two-hundred and sixty-seven of these patients underwent CABG surgery. Finally, we evaluated the results of 55 patients (23 females, 22 males; mean age 66.7±9.4 years; range 45 to 84 years) who had creatinine clearance values lower than 60 mg/kg/m2.

Results: Mortality occurred in two patients (8.6%) with mild glomerular filtration rate (GFR) decrease (0-25% decrease from preoperative GFR), in two patients (11.6%) with moderate decrease (25-50%) and in three patients (75%) with severe decrease (>50%). It was determined that GFR decrease in the postoperative period increased the likelihood of death (p=0.001). The odds ratio of death in the group with mild decrease in GFR increased 12.6 times, that in the group with moderate decrease increased 15.6 times and that in the group with severe decrease increased 35.2 times.

Conclusion: If the renal function in patients with chronic renal disease can be kept at the levels of preoperative values, postoperative early results are affected mildly. However, if acute exacerbation occurs, it increases the risk of mortality. This data also indicates that every effort to save renal function will decrease postoperative mortality.

Keywords : Chronic kidney disease; coronary artery bypass grafting; short term results
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