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Impact of preoperative mild renal dysfunction on short term outcome in isolated coronary artery bypass (CABG) patients

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Author(s): Ramakrishna M | Hegde Deviprasad | Kumarswamy G | Gupta Ratan | Moola Narayana | Suresh K

Journal: Indian Journal of Critical Care Medicine
ISSN 0972-5229

Volume: 12;
Issue: 4;
Start page: 158;
Date: 2008;
Original page

Keywords: CABG-coronary arteries bypass graft | CPB-cardiopulmonary bypass | GFR-glomerular filtration rate | Mild renal dysfunction

ABSTRACT
Background and Aim: It is well known that dialysis dependent renal failure increases the likelihood of poor outcome following cardiac surgery. But the results of CABG in patients with mild renal dysfunction are not clearly established. The aim of the study is to analyze the risk of preoperative mild renal dysfunction on outcome after isolated coronary surgery . Materials and Methods: We reviewed prospectively collected data between June 2006-Nov 2006 in 488 patients who underwent isolated CABG. We separated the data into two groups. Control group having normal renal function and study group having mild renal dysfunction (serum creatinine 1.4 mg-2.2 mg%). Among 488 patients, 412 patients were in control group and 76 patients were in the study group . Results : Analysis of data showed significant postoperative complications in the mild renal dysfunction group, like increased operative mortality (7.5% vs 1.6%), increased requirement of postoperative renal replacement therapy (10% vs 1.2%), increased incidence of new onset atrial fibrillation (20% vs 4.2%) and prolonged duration of ICU stay. Multivariate analysis adjusting for known risk factors confirmed preoperative mild renal dysfunction (S.creat.1.4-2.2 mg/dl) is an independent risk factor for postoperative morbidity and mortality. (Adj. OR: 4.47; 95% CI: 1.41-14.16; P=0.010). Conclusion: Mild renal dysfunction is an important independent predictor of outcome in terms of in-hospital mortality and morbidity in patients undergoing CABG.
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