Determinant Factors of Renal Failure after Coronary Artery Bypass Grafting with On-Pump Technique

Abstract

Objective: The aim of the present study was to investigate the determinant factors of acute renal failure (ARF) after isolated on-pump coronary artery bypass grafting (CABG). Subjects and Methods: This was a retrospective study of 13,315 adult patients who underwent isolated CABG with cardiopulmonary bypass (CPB) in Tehran Heart Center from May 2002 to May 2007. The exclusion criteria were age <18, concomitant cardiac and/or noncardiac surgical operations, history of renal failure before surgery, and chronic renal failure requiring dialysis. Preoperative and operative variables were measured, and a multivariate logistic regression model was constructed to identify the independent risk factors for developing renal failure after on-pump CABG. Results: Of the 13,315 patients, 3,347 (25.4%) and 90,883 (74.6%) were females and males, respectively, with a mean age of 58.63 ± 9.48 years. ARF was detected in 85 (0.6%) of the patients with isolated on-pump CABG. The mean age of the patients was 58.63 ± 9.48 years, and 25.5% of them were female. The multivariate logistic regression analysis identified age (OR = 1.035; p = 0.002), female gender (OR = 1.622; p = 0.037), history of peripheral vascular disease (PVD) (OR = 2.579; p = 0.042), diabetes mellitus (OR = 1.918; p < 0.001), emergent and urgent surgery (OR = 1.744 and OR = 7.901, respectively; p = 0.003), CPB time >70 min (OR = 1.944; p = 0.007), and intra-aortic balloon pump (IABP) insertion (OR = 10.181; p < 0.001) as the independent risk factors for ARF. Conclusion: The data showed that age, female gender, positive history of diabetes and PVD, urgent and emergent surgery, CPB time >70 min, and need for IABP were the independent determinant factors of ARF after on-pump CABG.