Cardiac surgery in moderate to end-stage renal failure: analysis of risk factors

Peppo, Alfonso Penta de; Nardi, Paolo; Paulis, Ruggero De; Pellegrino, A.; Forlani, Stefano; Scafuri, Antonio; Chiariello, Luigi

doi:10.1016/s0003-4975(02)03711-6

Cited by 30 publications

(15 citation statements)

References 9 publications

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“…Due to the ageing population, an increasing number of patients with chronic kidney disease will require valve replacement surgery (4,24). The presence and progression of cardiovascular and renal disease are related because of multiple shared risk factors (25).…”

Section: Discussionmentioning

confidence: 99%

“…There has also been a corresponding increase in the number of dialysis patients presenting for cardiac valve surgery (1,3,4). However, such a patient population presents a challenging Bioprosthetic versus mechanical prostheses for valve replacement in end-stage renal disease patients: systematic review and metaanalysis calcification and structural deterioration as caveats of bioprosthesis.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Bioprosthetic versus Mechanical Prostheses for Valve Replacement in End-stage Renal Disease Patients: Systematic review and meta-analysis

Phan

Tsai

Zhao

et al. 2016

Heart, Lung and Circulation

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Bioprosthetic versus Mechanical Prostheses for Valve Replacement in End-stage Renal Disease Patients: Systematic review and meta-analysis

Phan

Tsai

Zhao

et al. 2016

Heart, Lung and Circulation

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“…Studies have shown that non-dialysis-dependent renal insufficiency increases the risks of mortality and morbidity by 5-19 and 29-80%, respectively, after CABG surgery [12]. Moreover, mild renal insufficiency (a serum creatinine level of 1.4-2 mg/dL) is an independent determinant of AKI after CABG surgery [13]. …”

Section: Discussionmentioning

confidence: 99%

Effect of Prophylactic Dialysis on Morbidity and Mortality in Non-Dialysis-Dependent Patients after Coronary Artery Bypass Grafting: A Pilot Study

Borji

Ahmadi²,

Barkhordari³

et al. 2017

Nephron

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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.

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“…7,8 Moreover, the postoperative need for dialysis is associated with an early death rate exceeding 40%, regardless of pretransplant kidney function. 7 Renal function loss after HTA is common, and usually presents early in the first year.…”

Section: Discussionmentioning

confidence: 99%

Untitled

Goupil

Bonnardeaux²,

Boucher³

et al. 2014

Exp Clin Transplant

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Combined heart-kidney transplant has become an alternative for heart transplant candidates with significant chronic kidney disease. However, it is not clear which patients will benefit most from such intervention, and in whom cardiac transplant alone will be sufficient to restore adequate renal function. We report the case of a man with ischemic cardiomyopathy and chronic kidney disease who was wait-listed for heart-kidney transplant after acute decompensated heart failure and renal failure requiring hemodialysis. Because of unexpected circumstances, the kidney transplant was cancelled, and only a heart transplant was performed. Nonetheless, the kidney function rapidly improved beyond the levels before hospitalization and remains stable months after transplant.This case illustrates the difficulties in assessing the reversibility of kidney damage in the context of heart failure requiring transplant. This issue is primordial to improve selection of patients who will benefit most from combined heart-kidney transplant in a context of scarce organ allocation resources.

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Cardiac surgery in moderate to end-stage renal failure: analysis of risk factors

Cited by 30 publications

References 9 publications

Bioprosthetic versus Mechanical Prostheses for Valve Replacement in End-stage Renal Disease Patients: Systematic review and meta-analysis

Bioprosthetic versus Mechanical Prostheses for Valve Replacement in End-stage Renal Disease Patients: Systematic review and meta-analysis

Effect of Prophylactic Dialysis on Morbidity and Mortality in Non-Dialysis-Dependent Patients after Coronary Artery Bypass Grafting: A Pilot Study

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