Short-term Outcome of Coronary Artery Bypass Grafting in Patients Receiving Hemodialysis Compared to Patients Without Renal Failure

Abstract

Introduction: Coronary artery disease is a major cause of death in patients on maintenance hemodialysis (HD). The morbidity and mortality of coronary artery bypass grafting (CABG) for patients on chronic HD are reported to be high. In the present study, the outcome of CABG in a group of HD patients was examined.
Methods: We retrospectively analyzed the results of isolated CABG performed at Cairo University Medical Center from January 2000 to December 2008. Peri-operative data for 13 patients on maintenance HD were compared with data from 10 patients without kidney failure. The long-term results of the HD group were also examined.
Results: The HD group included 11 males and two females with a mean age of 59.5 ± 11.3 years. Complete revascularization rate tended to be lower in patients of this group. All-arterial revascularization was feasible for smaller number of patients in the HD group than the control group (46.1% versus 80%, P<0.03). The number of anastomoses, operation time, use of intra-aortic balloon pumping (IABP), blood loss, ICU stay and hospital stay were not different between the two groups. There was no statistically significant difference in hospital mortality between the two groups (15.4% versus 10%, P>0.05).
Patients in the HD group who underwent complete revascularization had a significantly better one year survival compared to HD patients with incomplete revascularization (70% versus 45%). Patients in the HD group who underwent complete revascularization had a five-year survival rate of 45%.
Conclusion: The operative risk of CABG in patients undergoing maintenance HD in this series was comparable to patients without kidney failure.

Keywords: Coronary Artery Bypass Grafting; Coronary Heart Disease; Hemodialysis; Renal Failure