Cardiac surgery in patients with chronic kidney disease

Abstract

Objective. To evaluate postoperative outcomes of various coronary artery bypass grafting (CABG) options in patients with chronic kidney disease (CKD): with and without cardiopulmonary bypass (CPB), combination with valve interventions. Material and methods. A retrospective analysis included 168 patients who underwent surgery between 2017 and 2024. Early postoperative complications, incidence of acute kidney failure (AKF), hospital-stay and mortality were compared depending on intervention. Results. The highest rate of complications, including dialysis-dependent acute kidney injury (AKI), was observed after combined surgical interventions (CABG+heart valve surgery). Off-pump CABG does not demonstrate any advantage in reducing the risk of AKI or mortality compared to on-pump CPB. The main risk factors of AKF were older age, male gender, reduced ejection fraction, diabetes mellitus and extent of surgery. Conclusion. CABG method in patients with CKD should take into account anatomical features of coronary arteries and severity of renal dysfunction. Despite potential advantages of off-pump CABG, its effectiveness in patients with CKD remains controversial and requires further research.