Predictive Value of Renal Dysfunction for Early and Long-Term Outcomes of Coronary Artery Bypass Grafting

Abstract

to assess value of renal dysfunction for immediate and long-term prognosis after coronary artery bypass grafting (CABG). We examined 657 patients (419 men and 238 women) aged 54-68 (60.6 ± 5.3) years before and after coronary artery bypass grafting (CABG). Patients with baseline glomerular filtration rate (GFR) > 90 and with GFR 89-45 ml/1.73 (n = 246) comprised groups 1 and 2, respectively. Acute kidney injury (AKI) was diagnosed using the AKI Network criteria. In early postoperative period AKI (perioperative AKI) was diagnosed in 97 (23.6%) and 102 (41.55) patients of group 1 and 2, respectively (χ² = 22.4; p < 0.001). Rate of early cardio-vascular complications and hospital mortality were significantly higher in patients with compared with those without perioperative AKI. During 12 months of follow-up 6.8% of patients in group 1 developed chronic kidney disease (CKD). In group 2 we noted progression of CKD in 14.7 and 5.4% (p > 0.05) and its regression in 45.1 and 61.4% (p = 0.004) of patients with and without perioperative AKI, respectively. Programmed hemodialysis was carried out in 12 patients of group 2, including 10 with perioperative AKI (p = 0.003). Presence of CKD and development of perioperative AKI was associated with unfavorable cardiorenal prognosis after CABG.