Clinical outcome for on-pump myocardial revascularization in patients with mild renal dysfunction

Thorac Cardiovasc Surg. 2005 Feb;53(1):46-51. doi: 10.1055/s-2004-830457.

Abstract

Background: Coronary artery disease is the major cause of death in patients with chronic renal failure. We studied the early and long-term outcome of patients with mild chronic renal impairment, preoperative regular diuresis, and normal potassium levels having undergone pump myocardial revascularization.

Methods: From January 1992 to December 2000, 67 patients with serum creatinine level higher than 1.7 mg/dl and less than 2.5 mg/dl underwent on-pump myocardial revascularization. The patients were divided into 2 groups and treated with renal doses of dopamine in the postoperative or preoperative period, respectively. A homogeneous group of 100 patients was selected as control.

Results: There were no statistically significant differences in mortality and morbidity between the two groups A, while there was a significant difference in cardiac and respiratory complications, ICU stay and LOS between the A and B group in the early and long-term follow-up. Survival at 12-year follow-up is significantly higher in the B group.

Conclusions: Patients with relatively mild renal insufficiency should be evaluated carefully for open cardiac surgery due to the significant increase in early and long-term morbidity and mortality.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Cardiotonic Agents / administration & dosage
  • Coronary Artery Bypass / methods*
  • Coronary Artery Disease / complications
  • Coronary Artery Disease / mortality*
  • Coronary Artery Disease / surgery
  • Dopamine / administration & dosage
  • Female
  • Humans
  • Kidney Failure, Chronic / complications
  • Kidney Failure, Chronic / mortality*
  • Male
  • Middle Aged
  • Odds Ratio
  • Survival Analysis
  • Time Factors

Substances

  • Cardiotonic Agents
  • Dopamine