Impact of chronic kidney disease on predictor of outcomes of Coronary Artery Bypass Grafting
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Abstract
Background: Chronic kidney disease (CKD), in particular, which requires dialysis, has been debated as a risk factor for adverse outcomes after coronary artery bypass grafting (CABG). Objectives: To determine the influence of preoperative CKD on postoperative hospital mortality in patients undergoing coronary artery bypass grafting (CABG). Methods: This study is a retrospective study on CKD and predictors of the mortality rate of cardiopulmonary bypass surgery. The data were collected from patients in Phramongkutklao Hospital, who were diagnosed with cardiopulmonary heart disease and required a surgical treatment, from 2012 to 2017. Results: There were a total of 764 patients. The patients were categorized by the stage of chronic kidney disease in 4 stages: 82 patients (10.73%) were diagnosed with normal CKD, 245 patients (32.07%) were diagnosed with mild CKD, 268 patients (35.08%) were diagnosed with moderate CKD, and 169 patients (22.12%) were diagnosed with severe CKD. The normal CKD group had the average cardiopulmonary bypass time of 125.06 ± 62.18 minutes and the average cross-clamping time of 89.82 ± 45.19 minutes. The rate of in-hospital mortality was 3 patients (3.7%). Moreover, the mild CKD group had the average cardiopulmonary bypass time of 115.44 ± 48.19 minutes and the average cross-clamping time of 85.54 ± 40.69 minutes. The rate of in-hospital mortality was 7 patients (2.9%). Meanwhile, the moderate CKD group had the average cardiopulmonary bypass time of 111.88 ± 47.21 minutes and the average cross-clamping time of 82.75 ± 37.79 minutes, with the in-hospital mortality rate of 18 patients (6.7%). The severe CKD group, the average cardiopulmonary bypass time and the average cross-clamping time were 126.69 ± 58.38 minutes and 89.74 ± 41.19 minutes, respectively; while the mortality rate was 25 patients (14.8%). Conclusions: According to the results, these predictors were severe CKD, emergency operation status, old age, decrease ejection fraction.
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References
Vejakama P, Ingsathit A, Attia J, Thakkinstian A. Epidemiological Study of Chronic Kidney Disease Progression: A large-Scale PopulationBased Cohort Study. Bangkok : National Research Council of Thailand.;2015. p.1-45.
Nwiloh JO, Obialo CI. Heart surgery in end-stage renal disease: is outcome worse for african american patients? Open J Cardiovasc Surg. 2013;6:21-6.
Minakata K, Bando K, Tanaka S, Takanashi S, Konishi H, Miyamoto Y, et al. Preoperative chronic kidney disease as a strong predictor of postoperative infection and mortality after coronary artery bypass grafting. Circ J. 2014;78(9):2225-31.
Go AS, Chertow GM, Fan D, McCulloch CE, Hsu CY. Chronic kidney disease and the risks of death, cardiovascular events, and hospitalization. N Engl J Med. 2004;351(13):1296-305.
Domoto S, Tagusari O, Nakamura Y, Takai H, Seike Y, Ito Y, et al. Preoperative estimated glomerular filtration rate as a significant predictor of long-term outcomes after coronary artery bypass grafting in Japanese patients. Gen Thorac Cardiovasc Surg. 2014;62(2):95-102.
Rahmanian PB, Adams DH, Castillo JG, Vassalotti J, Filsoufi F. Early and late outcome of cardiac surgery in dialysis-dependent patients: single-center experience with 245 consecutive patients. J Thorac Cardiovasc Surg. 2008;135(4):915-22.
KDIGO AKI Work Group. KDIGO clinical practice guideline for acute kidney injury. Kidney Int Suppl. 2012;2(Suppl. 1):1-138.
Ohira S, Doi K, Numata S, Yamazaki S, Kawajiri H, Yaku H. Impact of Chronic Kidney Disease on Long-Term Outcome of Coronary Artery Bypass Grafting in Patients with Diabetes Mellitus. Circ J. 2016;80(1):110-7.
