Background/Aims: Coronary artery bypass grafting (CABG) is associated with an increased risk of morbidity and mortality in patients with pre-existing renal dysfunction. Numerous measures have been implemented to overcome this problem; however, no improvement in outcomes has been achieved. This study was aimed at investigating the effects of prophylactic dialysis on mortality and morbidity in these patients. Methods: This randomized-controlled clinical trial enrolled 88 non-dialysis-dependent patients with chronic kidney disease awaiting CABG surgery. Thirty-nine randomly selected patients received dialysis 3 times prior to surgery, and 49 patients formed the control group. Kaplan-Meier analysis and Cox proportional-hazards models were used to identify factors associated with survival. Results: There was no significant difference in the development of morbidities between the groups (p = 0.413). A significant difference was evident in the average survival time (p = 0.037). Cox proportional-hazards models determined that the hazard ratio of death after surgery was 10.854-fold greater in non-dialysis patients than in patients who received dialysis (hazard ratio = 2). Conclusion: Prophylactic dialysis prior to CABG decreases mortality, but does not affect morbidity, in patients with renal insufficiency.
Type 2 autoimmune polyglandular (Schmidt) syndrome (APS-2) is defined by the occurrence of at least 2 out of 3 of the following manifestations, Addison's disease, Hypothyroidism and Type 1 diabetes mellitus. APS-2 is a rare condition with an incidence of 1-2/100 000 per year. Prevalence of APS-2 is most happening in the range of 20-40 years of age. Here we present a patient who complained about loss of appetite with significant weight loss also having trouble with her skin saying she had experienced progressively darkening of the skin all over her body and manifestations of Addison's disease at the age of 70. The patient was treated with oral Prednisolone, Fludrocortisone and Levothyroxine and evaluated after one month which showed the hormonal panel within the normal range.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.