Advanced Kidney Disease (CKD) Linked to Worse Post-Bypass Outcomes
Severe CKD raised the risk of in-hospital death after coronary artery bypass grafting surgery.
Advanced preoperative chronic kidney disease (CKD) among patients undergoing coronary artery bypass grafting (CABG) strongly predicts in-hospital death and the development of acute kidney injury and postoperative infection, according to researchers.
Kenji Minakata, MD, PhD, of Kyoto University Graduate School of Medicine in Kyoto, Japan, and colleagues retrospectively studied 1,522 patients who underwent CABG, classifying them according to preoperative estimated glomerular filtration rate (eGFR): greater than 90 mL/min/1.73 m2 (normal); 60-90 mL/min/1.73 m2 (mild CKD); 30-59 mL/min/1.73 m2 (moderate CKD); and less than 30 mL/min/1.73 m2 (severe CKD). Of the 1,522 subjects, 121 (8%) had normal renal function, 713 (47%) had mild CKD, 515 (34%) had moderate CKD, and 169 (11%) had severe CKD.
In multivariate analysis, patients with severe CKD had a significant 3.3-fold increased risk of in-hospital death compared with patients who had no or mild CKD, Dr. Minakata's team reported online in the Circulation Journal.
Patients with moderate and severe CKD had a significant 5.1 and 14.8 times increased risk of acute kidney injury, respectively, compared with those who had no or mild CKD. Patients with severe CKD had a 2.5 times increased risk of postoperative infection.