Late dialysis rate for coronary artery bypass grafting patients with moderate-to-severe renal impairment: comparison between off-pump and conventional method

Abstract

Patient characteristics, rather than operative strategy of using off-pump or conventional coronary artery bypass grafting, influence the mid-term mechanical renal replacement therapy rate for patients with glomerular filtration rates <60 ml/min.

Results of Low-Dose Human Atrial Natriuretic Peptide Infusion in Nondialysis Patients With Chronic Kidney Disease Undergoing Coronary Artery Bypass Grafting

“…There was also a significant difference (0.8% vs. 5.2%) in the rate of commencing dialysis, and the 3-year survival rate was 93% versus 81%, being significantly lower in the mild RD patients (4). In a 4-year post-operative follow-up study, Yu et al (5) found that a pre-operative estimated glomerular filtration rate (eGFR) of 60 ml/min or less was a more important risk factor for postoperative dialysis than the choice of off-pump or on-pump surgery.…”

Commentary: We have mastered off-pump coronary artery bypass grafting technique, but not the indications for it

“…A smaller trial that randomly allocated only patients with preoperative renal insufficiency (glomerular filtration rate <60 mL/min/ 1.73 m 2 ) demonstrated reduced rates of short-term (5 days) AKI with OPCAB, 9 with no assessment of longer-term outcomes. In a retrospective study of more than 2000 patients from 2 hospitals in Taiwan, 10 OPCAB was associated with a reduced incidence of short-term (in-hospital) renal failure requiring dialysis in patients with severe renal insufficiency (glomerular filtration rate <30 mL/h), although this effect was lost after controlling for preoperative renal function. No difference was seen in long-term (4-year follow-up).…”