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Thorac Cardiovasc Surg 2009; 57(8): 460-463
DOI: 10.1055/s-0029-1185877
Original Cardiovascular

© Georg Thieme Verlag KG Stuttgart · New York

The Impact of Pre- and Postoperative Renal Dysfunction on Outcome of Patients Undergoing Coronary Artery Bypass Grafting (CABG)[*]

J. Litmathe1 , M. Kurt1 , P. Feindt1 , E. Gams1 , U. Boeken1
  • 1Department of Thoracic- and Cardiovascular Surgery, Heinrich-Heine University, Duesseldorf, Germany
Further Information

Publication History

received February 23, 2009

Publication Date:
14 December 2009 (online)

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Abstract

Objective: Acute changes in renal function after elective coronary bypass surgery represent a challenging clinical problem. In this study, we evaluated perioperative risk factors for the development of postoperative renal dysfunction (PRD), and the impact of such an event on the perioperative course. Additionally, we investigated the influence of preoperatively mildly increased serum creatinine on perioperative mortality and morbidity. Methods: We retrospectively analyzed data of 2511 patients undergoing isolated CABG between 2004 and 2007 with a preoperative serum creatinine ≤ 2.2 mg/dL. There were 592 patients with a preoperative serum creatinine of between 1.4 and 2.2 mg/dl (mild renal dysfunction group) and 1919 patients with a serum creatinine < 1.4 mg/dl. Perioperative risk factors for PRD were analyzed by multivariate regression analysis. Results: Global in-hospital mortality was 3.1 %.The incidence of PRD was 6.2 %. Mortality for patients who had PRD was 7.8 vs. 2.9 % for patients who did not (p < 0.05). PRD increased the length of hospital stay by 3.7 days (12.2 vs. 15.9; p < 0.05). Multivariate logistic regression identified the following variables as independent predictors of PRD: age, angina class III/IV, diabetes mellitus, prolonged cardiopulmonary bypass time, and preoperative serum creatinine. With regard to preoperative renal function, we found that operative mortality was higher in the mild renal dysfunction group (5.7 % vs. 2.5 %; p < 0.05). New dialysis/hemofiltration (5.1 % vs. 1.2 %; p < 0.05) and postoperative stroke (5.1 % vs. 1.6 %; p < 0.05) were also more common in these patients. Conclusions: Mild renal dysfunction preoperatively is an important predictor of outcome after CABG. In these patients, PRD dramatically increases mortality, morbidity and length of hospital stay.

Key words

coronary bypass surgery - renal dysfunction - patient outcome

1 The content of this paper was presented during the 38th annual meeting of the German Society of Thoracic- and Cardiovascular Surgery on Feb. 15th–18th, 2009 in Stuttgart/ Germany.

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1 The content of this paper was presented during the 38th annual meeting of the German Society of Thoracic- and Cardiovascular Surgery on Feb. 15th–18th, 2009 in Stuttgart/ Germany.

Dr. MD, PhD Jens Litmathe

Department of Thoracic- and Cardiovascular Surgery
Heinrich-Heine-University

Moorenstraße 5

40225 Duesseldorf

Germany

Phone: + 49 17 32 73 86 81

Fax: + 49 21 18 11 83 33

Email: jens-litmathe@t-online.de

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