Renal Failure after Coronary Bypass Surgery and the Associated Risk Factors

Reyhanoğlu, Hasan; Özcan, Kaan; Ertürk, Murat; Îslamoğlu, Fatih; Durmaz, İsa

doi:10.1532/hsf.1216

Cited by 4 publications

(2 citation statements)

References 18 publications

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“…The association between CABG and postoperative renal failure is well-known and potentiated by diabetes and other factors that lead to microcirculatory impairment and atherosclerosis. 13 Generally, glomerulonephritis and diabetes are the most important risk factors for renal failure. 14 Still, in the present study, the risk of renal failure was markedly higher during the first postoperative year (HR 36.6) than during years five-to-15 after the surgery (HR 5.2), revealing the key role of CABG surgery as a risk factor for acute renal failure.…”

Section: Discussionmentioning

confidence: 99%

Predictors and Outcomes of Coronary Artery Bypass Grafting: A Systematic and Untargeted Analysis of More Than 120,000 Individuals and 1,300 Disease Traits

Aittokallio

Kauko

Palmu

et al. 2021

Journal of Cardiothoracic and Vascular Anesthesia

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Objective: To perform an untargeted data-driven analysis on the correlates and outcomes of coronary artery bypass grafting (CABG). Design: FinnGen cohort study. Setting: The authors collected information on up to 1,327 disease traits before and after CABG from nationwide healthcare registers. Participants: A mixed population and patient sample of 127,911 individuals including 3,784 CABG patients. Interventions: The authors assessed the association between (1) traits and incident CABG and (2) CABG and incident traits using multivariateadjusted Cox models. Main results: Patients who underwent CABG and were in the fourth quartile of a risk score based on the top predictors of mortality had 12.2-fold increased risk of dying (95% confidence interval [CI], 10.3-14.5) compared with those in the first quartile. Cardiovascular disease (CVD) and CVD risk factors were most strongly associated with incident CABG. However, CABG was associated with death due to cardiac causes (hazard ratio [HR], 3.7; 95% CI, 3.5-4.0) or other causes (HR, 2.5; 95% CI, 2.4-2.7). CABG also was related to increased risk of several non-CVD traits, including anemia (

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Section: Discussionmentioning

confidence: 99%

Predictors and Outcomes of Coronary Artery Bypass Grafting: A Systematic and Untargeted Analysis of More Than 120,000 Individuals and 1,300 Disease Traits

Aittokallio

Kauko

Palmu

et al. 2021

Journal of Cardiothoracic and Vascular Anesthesia

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“…PD is the preferred treatment for ARF after heart surgery at our center because PD is relatively easy to employ, and severe complications from PD are rare. The indications for the initiation of modified PD in our center include: urine output <0.5 mL/kg/h for more than four hours; unresponsive to adjustment in fluid therapy, diuretic therapy, or the optimization of vasoactive drugs; postoperative creatinine levels more than double the initial values or more than 115mmol/L; severe edema and congestive heart failure; potassium > 5.5mmol/L; severe metabolic acidosis; low cardiac output syndrome; or any combination thereof [Reyhanoglu 2015]. Metabolic acidosis was considered severe if it failed to be corrected after intravenous sodium bicarbonate infusion, adjustment of fluid status, and positive inotropic drugs support.…”

Section: Patientsmentioning

confidence: 99%

Modified Peritoneal Dialysis for Treatment of Acute Renal Failure after Complex Congenital Heart Surgery in Infants

Zhang

Jin

Zhang

et al. 2018

HSF

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Background: Acute kidney injury (AKI) is one of the common complications in infants and children after complex congenital heart surgery. Peritoneal dialysis (PD) is usually applied for renal replacement therapy (RRT), especially in infants. We investigated the efficacy and safety of modified PD for the treatment of acute renal failure and congestive heart failure after cardiac surgery for congenital heart disease in infants. Methods: We retrospectively analyzed five consecutive patients from October 2015 to February 2017. The patients were aged from four days to five years old, and all had acute renal failure and congestive heart failure after cardiac surgery. In the five patients treated with modified PD (five males; average weight: 11.2 ± 5.5 kg), we used the Seldinger technique percutaneous abdominal puncture 16 G single lumen central venous catheter instead of the Tenckhoff peritoneal dialysis catheter as a PD catheter. Modified PD was intermittent. We recorded and monitored circulation and metabolism index.Results: Five cases (100%) with modified PD were restored to normal renal function. Congestive heart failure was gradually alleviated, and pulmonary and cardiovascular function were improved. Urine volume increased. Neither peritonitis nor catheter leakage occured in any of our cases. Urine volume increased due to PD, from 0.16 + 0.18 mL/kg*h before PD to 2.63 + 1.05 ml/kg*h at the end of PD (P < .05). Serum creatinine, serum urea nitrogen, and serum K+ changed from 85.0 ± 36.5 µmol/L, 17.1 ± 7.5 mmol/L, and 4.57 ± 0.30 mmol/L before PD, to 76.0 ± 36.7 µmol/L, 20.1 ± 11.0 mmol/L, and 4.42 ± 0.42 mmol/L at the end of PD, respectively (P > .05). Acidosis, hyperkalemia, hypoxemia and low cardiac output syndrome were improved. All patients were cured and discharged with normal renal function. Conclusions: We conclude that modified single lumen central venous catheter for PD is a safe, feasible, and less invasive therapeutic strategy for AKI in infants undergoing cardiac surgery, and is worthy of being widely applied in clinical practice.

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