Relation between renal failure and in-hospital complications in patients with coronary artery disease, undergoing coronary artery bypass grafting

Authors: K.S. Shafranskaya, М.V. Zykov, I.S. Bykova, V.V. Kalaeva, M.V. Evseeva, S.V. Ivanov, V.V. Kashtalap, V.N. Karetnikova, O.L. Barbarash.


For citation: Shafranskaya KS, Zykov МV, Bykova IS, at al. Relation between renal failure and in-hospital complications in patients with coronary artery disease, undergoing coronary artery bypass grafting. Kreativnaya kardiologiya. 2013; 2: 5-14 (in Russian).

Keywords: coronary artery bypass grafting renal failure the outcome of the hospital period

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Abstract

Objective. To evaluate the incidence of renal failure (RF) and its impact on in-hospital outcomes in patients undergoing coronary artery bypass grafting (CABG).

Material and methods. 719 patients, who have undergone CABG, were included in the study. All the patients underwent preoperative measurement of serum creatinine levels and estimation glomerular filtration rate (GFR) using the Modification of Diet in Renal Disease (MDRD) formula, as well as scoring with the additive EuroSCORE scale.

Results. A baseline value for GFR was 60 ml/min/ 1.73 m2; it suggested great impact on early clinical outcomes in patients undergoing CABG. There were no significant differences in the preoperative clinical status of patients with and without renal failure. However, the number of deaths, myocardial infarctions, the progression of renal failure, bleedings, caused by re-mediastinotomy, as well as extracardiac complications were more often observed in patients presenting with renal failure in the in-hospital period. Patients with moderate-high risk according to their additive EuroSCORE value were more likely to have RF compared to low risk patients.

Conclusion. All groups at risk, suffering from RF, (EuroSCORE) have reported higher incidence of complications within the in-hospital period after CABG; thus, renal failure, detected through the estimation of GFR level, have contributed greatly to the worsening of the current prognosis.

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Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, President of Bakoulev National Medical Research Center for Cardiovascular Surgery