ISSN : 1301-5680
e-ISSN : 2149-8156
Turkish Journal of Thoracic and Cardiovascular Surgery     
Impacts of non-dialysis-dependent renal insufficiency on the early surgical outcomes after isolated coronary artery bypass graft surgery
Jamshid Bagheri1, Mohammad Jebelli1, Ali Kord Valeshabad2, 3, Amin Bagheri1, Mohammad Hussein Mandegar1
1Tehran University of Medical Sciences, Cardiac Surgery and Transplantation Research Center, Tehran, Iran
2Division of Gastroenterology and Hepatology, Department of Medicine, Johns Hopkins University, Baltimore, USA
3Farzan Clinical Research Institute, Tehran, Iran
DOI : 10.5606/tgkdc.dergisi.2013.8130
Background: This study aims to investigate the effects of non-dialysis-dependent renal dysfunction on postoperative mortality and complications assessed by creatinine clearance and serum creatinine.

Methods: Between August 2007 and March 2011, a total of 1,359 consecutive patients (975 females, 384 males; mean age 58.6±10.1 years; range 23 to 87 years) who underwent isolated coronary artery bypass grafting (CABG) surgery in Shariati Hospital, Tehran, Iran were retrospectively analyzed. Patients were classified based on the preoperative creatinine clearance values to group renal (group R; n=21) (<30 mL/min) and group control (group C; n=1338) (≥30 mL/min). Two groups were compared for preoperative characteristics. Effects of preoperative renal insufficiency on post-CABG mortality and morbidity rates were measured using stepwise multivariate logistic regression analyses.

Results: Post-coronary artery bypass grafting surgery renal failure (9.5% vs. 0.4%) and mortality rates (19.0% vs. 3.3%) were higher in group R compared to group C (p<0.001). Renal impairment was an independent predictor for post- CABG surgery renal insufficiency and dialysis (OR=1.05, 95% CI: 1.02-1.07; p=0.001) and early mortality (OR=1.16, 95% CI: 1.07-1.25; p=0.001).

Conclusion: Preoperative non-dialysis-dependent renal insufficiency is the most important risk factor for post-CABG surgery renal failure and mortality. A specific attention is warranted to patients with pre-existing risk factors especially renal impairments.

Keywords : Coronary artery bypass graft; mortality; non-dialysisdependent renal insufficiency
Viewed : 9506
Downloaded : 1981