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Relation between mild renal dysfunction and outcomes after coronary artery bypass grafting.
Circulation. 2005 Aug 30; 112(9 Suppl):I270-5.Circ

Abstract

BACKGROUND

Risk stratification algorithms for coronary artery bypass grafting (CABG) do not include a weighting for preoperative mild renal impairment defined as a serum creatinine 130 to 199 micromol/L (1.47 to 2.25 mg/dL), which may impact mortality and morbidity after CABG.

METHODS AND RESULTS

We reviewed prospectively collected data between 1997 and 2004 on 4403 consecutive patients undergoing first-time isolated CABG with a preoperative serum creatinine <200 micromol/L (2.26 mg/dL)] in a single institution. The in-hospital mortality was 2.5% (112 of 4403), the need for new dialysis/hemofiltration was 1.3% (57 of 4403), and the stroke rate was 2.5% (108 of 4403). There were 458 patients with a serum creatinine 130 to 199 micromol/L or 1.47 to 2.25 mg/dL (mild renal dysfunction group) and 3945 patients with a serum creatinine <130 micromol/L (<1.47 mg/dL). Operative mortality was higher in the mild renal dysfunction group (2.1% versus 6.1%; P<0.001) and increased with increasing preoperative serum creatinine level. New dialysis/hemofiltration (0.8%versus 5.2%; P<0.001) and postoperative stroke (2.2% versus 5.0%; P<0.01) were also more common in the patients with mild renal impairment. Multivariate analysis adjusting for known risk factors confirmed preoperative mild renal impairment (creatinine 130 to 199 micromol/L or 1.47 to 2.25 mg/dL; odd ratio, 1.91; 95% CI, 1.18 to 3.03; P=0.007) or glomerular filtration rate estimates <60 mL/min per 1.73 m2, derived using the Cockroft-Gault formula, (odds ratio, 1.98; 95% CI, 1.16 to 3.48; P=0.015) as independent predictors of in-hospital mortality. Preoperative mild renal dysfunction adversely affected the 3-year survival probability after CABG (93% versus 81%; P<0.001).

CONCLUSIONS

Mild renal dysfunction is an important predictor of outcome in terms of in-hospital mortality, morbidity, and midterm survival in patients undergoing CABG.

Authors+Show Affiliations

University Hospital Birmingham, Edgbaston B15 2TH, United Kingdom.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

16159830

Citation

Zakeri, Rosita, et al. "Relation Between Mild Renal Dysfunction and Outcomes After Coronary Artery Bypass Grafting." Circulation, vol. 112, no. 9 Suppl, 2005, pp. I270-5.
Zakeri R, Freemantle N, Barnett V, et al. Relation between mild renal dysfunction and outcomes after coronary artery bypass grafting. Circulation. 2005;112(9 Suppl):I270-5.
Zakeri, R., Freemantle, N., Barnett, V., Lipkin, G. W., Bonser, R. S., Graham, T. R., Rooney, S. J., Wilson, I. C., Cramb, R., Keogh, B. E., & Pagano, D. (2005). Relation between mild renal dysfunction and outcomes after coronary artery bypass grafting. Circulation, 112(9 Suppl), I270-5.
Zakeri R, et al. Relation Between Mild Renal Dysfunction and Outcomes After Coronary Artery Bypass Grafting. Circulation. 2005 Aug 30;112(9 Suppl):I270-5. PubMed PMID: 16159830.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Relation between mild renal dysfunction and outcomes after coronary artery bypass grafting. AU - Zakeri,Rosita, AU - Freemantle,Nick, AU - Barnett,Vivian, AU - Lipkin,Graham W, AU - Bonser,Robert S, AU - Graham,Timothy R, AU - Rooney,Stephen J, AU - Wilson,Ian C, AU - Cramb,Robert, AU - Keogh,Bruce E, AU - Pagano,Domenico, PY - 2005/9/15/pubmed PY - 2006/2/24/medline PY - 2005/9/15/entrez SP - I270 EP - 5 JF - Circulation JO - Circulation VL - 112 IS - 9 Suppl N2 - BACKGROUND: Risk stratification algorithms for coronary artery bypass grafting (CABG) do not include a weighting for preoperative mild renal impairment defined as a serum creatinine 130 to 199 micromol/L (1.47 to 2.25 mg/dL), which may impact mortality and morbidity after CABG. METHODS AND RESULTS: We reviewed prospectively collected data between 1997 and 2004 on 4403 consecutive patients undergoing first-time isolated CABG with a preoperative serum creatinine <200 micromol/L (2.26 mg/dL)] in a single institution. The in-hospital mortality was 2.5% (112 of 4403), the need for new dialysis/hemofiltration was 1.3% (57 of 4403), and the stroke rate was 2.5% (108 of 4403). There were 458 patients with a serum creatinine 130 to 199 micromol/L or 1.47 to 2.25 mg/dL (mild renal dysfunction group) and 3945 patients with a serum creatinine <130 micromol/L (<1.47 mg/dL). Operative mortality was higher in the mild renal dysfunction group (2.1% versus 6.1%; P<0.001) and increased with increasing preoperative serum creatinine level. New dialysis/hemofiltration (0.8%versus 5.2%; P<0.001) and postoperative stroke (2.2% versus 5.0%; P<0.01) were also more common in the patients with mild renal impairment. Multivariate analysis adjusting for known risk factors confirmed preoperative mild renal impairment (creatinine 130 to 199 micromol/L or 1.47 to 2.25 mg/dL; odd ratio, 1.91; 95% CI, 1.18 to 3.03; P=0.007) or glomerular filtration rate estimates <60 mL/min per 1.73 m2, derived using the Cockroft-Gault formula, (odds ratio, 1.98; 95% CI, 1.16 to 3.48; P=0.015) as independent predictors of in-hospital mortality. Preoperative mild renal dysfunction adversely affected the 3-year survival probability after CABG (93% versus 81%; P<0.001). CONCLUSIONS: Mild renal dysfunction is an important predictor of outcome in terms of in-hospital mortality, morbidity, and midterm survival in patients undergoing CABG. SN - 1524-4539 UR - https://www.unboundmedicine.com/medline/citation/16159830/Relation_between_mild_renal_dysfunction_and_outcomes_after_coronary_artery_bypass_grafting_ L2 - https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.104.522623?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -