Acute on Chronic Renal Failure has Worse Postoperative Outcomes than End-Stage Renal Disease Following Cardiac Surgery
Journal Title: International Journal of Vascular Surgery and Medicine - Year 2017, Vol 3, Issue 2
Abstract
Background: Renal failure is a systemic disorder and has destructive effects among all organs including cardiovascular system. The development of postoperative acute kidney injury has been recognized as one of the strongest risk factor for mortality in patients undergoing cardiac surgery. Aim/Objective: To investigate postoperative course of acute on chronic renal failure after cardiac surgery and define perioperativerisk factors for predicting postoperative acute renal failure (ARF) development. Materials and Methods: From January 2006 to December 2014, data of 3038 patients undergone cardiac surgery was retrospectively reviewed. Data of 42 chronic renal failure (CRF) patients who undergone dialysis at early postoperative period (≤30 days after cardiac surgery) were selected and evaluated. Group 1 (n=18) was consisted of patients who have preoperative dialysis dependent CRF and undergone dialysis after cardiac surgery, while Group 2 (n=24) was consisted of patients who have preoperative dialysis non-dependent CRF and undergone dialysis after cardiac surgery. Preoperative clinical characteristics and demographics, operational data of patients as well as postoperative outcomes of patient groups were analyzed, hereby a comparison of two groups was performed. Results: There were not statistically difference between groups for neuropsychiatriccomplications, wound infectious complications, septiccomplications, reexploration, duration of ventilation, cardioversion, intraaortic balloon pump support, pleural effusion, pericardial effusion and total drainage amounts. Positive inotropic necessity, significant electrocardiographicchanges, reintubation necessity and transfusion amounts were statistically higher in Group 2. Patients in Group 2 had a significant longer intensive care unit (ICU) stay (mean length of ICU stay was 4 days in Group 1, while 6 days in Group 2, p = 0.01) and total hospital stay (mean length of total hospital stay was 9 days in Group 1, while 15 days in Group 2, p = 0.006). Thirty-day mortality rate was statistically higher in Group 2 (p = 0.044). Conclusion: End stage renal failure is one of the worst preoperative risk factor for cardiac surgery but postoperative ARF development results with worst outcomes even patients had preoperative dialysis non-dependent CRF. So preoperative estimated glomerular filtration rate should be calculated to estimate ARF development risk, instead of evaluating with only serum creatinine.
Authors and Affiliations
Durgun Barış, Yüksel Ahmet, Erol Gökhan, Kobuk Mevlüt, Doğancı Suat
Keywords
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- EP ID EP347169
- DOI 10.17352/2455-5452.000024
- Views 54
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