In-Hospital Outcomes of Acute Renal Failure Requiring Continuous Renal Replacement Therapy in Patients with On-pump CABG.
- Author:
Young Du KIM
1
;
Kuhn PARK
;
Kuhn Hyun JO
;
Chul Ung KANG
;
Jeong Seob YOON
;
Seok Whan MOON
;
Young Pil WANG
Author Information
1. Department of Thoracic and Cardiovascular Surgery, College of Medicine Kangnam St. Mary's Hospital, The Catholic University of Korea, Korea. khjo@catholic.ac.kr
- Publication Type:Original Article
- Keywords:
Coronary artery bypass;
Acute renal failure
- MeSH:
Acute Kidney Injury*;
Coronary Artery Bypass;
Creatinine;
Hemodynamics;
Hospital Mortality;
Humans;
Incidence;
Kidney Failure, Chronic;
Length of Stay;
Mortality;
Renal Replacement Therapy*;
Survivors;
Transplants
- From:The Korean Journal of Thoracic and Cardiovascular Surgery
2007;40(1):32-36
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: Although acute renal failure (ARF) after coronary artery bypass graft (CABG) is relatively rare, but devastating complication with high mortality. Our study aims to evaluate the effectiveness of early application of CRRT in patients with ARF which developed after on-pump CABG. MATERIAL AND METHOD: Two hundred and eighty seven patients underwent isolated on-pump CABG between May 2002 and Feb. 2006 at our institution, of whom 15 (5.2%) needed CRRT (11 patients for postoperatively developed ARF and the remaining 4 patients with pre- existing dialysis-dependent chronic renal failure (CRF) for postoperative hemodynamic and metabolic control). Criteria for early application of CRRT were as follows; decreased urine output less than 0.5 cc/h/kg for 2 consecutive hours and elevated serum creatinine level greater than 2.0 mg/dL. RESULT: The incidence of ARF requiring CRRT after on-pump CABG was 3.9% (11/283) and the overall hospital mortality of patient with CRRT was 33.3% (5/15). Of 5 deaths, 4 were patients with postoperatively developed ARF, and 1 was a patient with pre-existing dialysis- dependent CRF patient. The mean time between the operation and the initiation of CRRT was 25.8+/-5.8 hours and the mean duration of CRRT was 62.1+/-41.2 hours. Of the 7 survivors who were not on dialysis-dependent preoperatively, 6 patients fully recovered renal function during hospital stay and 1 patient required permanent renal supportive treatment after discharge from hospital. CONCLUSION: Early application of CRRT could maintain stable postoperative hemodynamic status and make outcomes better than those of previous reports in patients with ARF which developed after on-pump CABG.
