Clinical outcome for on-pump myocardial revascularization in patients with mild renal dysfunction.
BACKGROUND
Coronary artery disease is the major cause of death in patients with chronic renal failure. We studied the early and long-term outcome of patients with mild chronic renal impairment, preoperative regular diuresis, and normal potassium levels having undergone pump myocardial revascularization.


METHODS
From January 1992 to December 2000, 67 patients with serum creatinine level higher than 1.7 mg/dl and less than 2.5 mg/dl underwent on-pump myocardial revascularization. The patients were divided into 2 groups and treated with renal doses of dopamine in the postoperative or preoperative period, respectively. A homogeneous group of 100 patients was selected as control.


RESULTS
There were no statistically significant differences in mortality and morbidity between the two groups A, while there was a significant difference in cardiac and respiratory complications, ICU stay and LOS between the A and B group in the early and long-term follow-up. Survival at 12-year follow-up is significantly higher in the B group.


CONCLUSIONS
Patients with relatively mild renal insufficiency should be evaluated carefully for open cardiac surgery due to the significant increase in early and long-term morbidity and mortality.
Monaco
M
M
Department of Cardiac Surgery, University "Federico II", Naples, Italy. mariomonaco55@libero.it
Di Tommaso
L
L
Mottola
M
M
Stassano
P
P
Iannelli
G
G
D000368:Aged; D002316:Cardiotonic Agents / Q000008:administration & dosage; D001026:Coronary Artery Bypass / Q000379:methods*; D003324:Coronary Artery Disease / Q000150:complications / Q000401:mortality* / Q000601:surgery; D004298:Dopamine / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D016019:Survival Analysis; D013997:Time Factors
D002316:Cardiotonic Agents; D004298:Dopamine