The Mortality Following Coronary Artery Bypass Grafting in Patients with Dialysis-Dependent Renal Failure and the Risk Factor for the Prognosis

(Center for Cardiovascular Surgery, Kishiwada Tokushukai Hospital, Kishiwada, Japan)

Shuhei Azuma Shin-ichi Higashiue Toshihiro Kawahira
Keiji Matsubayashi Hisashi Tonda Masatoshi Komooka
Norihiko Hiramatsu On-ichi Furuya
There were 3,129 consecutive patients who underwent CABG by only one operator at Kishiwada Tokushukai Hospital between January 1991 and December 2010. These patients included 236 patients requiring chronic renal hemodialysis at the time of operation. They consisted of 181 men and 55 women, with an average age of 64.1±9.7 years. The mean duration of hemodialysis was 10.1±20.4 years. Diabetic nephropathy(133 cases, 56.4%)was the most common disease leading to required for hemodialysis. The operative mortality and the hospital mortality were 3.4% and 6.4% respectively. The 1-year survival rate, the 3-year survival rate, the 5 year survival rate and the 10-year survival rate were 72.4%, 48.3%, 32.4% and 14.3%. Multivariate logistic analysis revealed that only peripheral artery disease(PAD)was a significant risk factor for mortality(p<0.05). The infectious diseases were the most common cause of long term death(24.1%). The mortality rates of CABG in patients with dialysis-dependent renal failure are still higher than those for non-hemodialysis patients. Our data suggest that PAD is a great risk factor for mortality following CABG in hemodialysis patients.
  Jpn. J. Cardiovasc. Surg. 41:224-227(2012)

Keywords:chronic dialysis patient, coronary bypass operation, remote results, PAD