Long-term outcome of patients who require renal replacement therapy after cardiac surgery.
OBJECTIVE
Acute renal failure is a serious complication of cardiac surgery. We studied the long-term survival and quality of life of patients requiring renal replacement therapy after cardiac surgery, since they represent a heavy burden on hospital resources and their outcome has never been adequately evaluated.


METHODS
Out of 7846 consecutive cardiac surgical patients, 126 (1.6%) required postoperative renal replacement therapy: their preoperative status and hospital course was compared with patients who had no need of postoperative renal replacement therapy. A multivariate analysis identified predictors of renal replacement therapy. Long-term survival and quality of life was collected in patients who had renal replacement therapy and in case-matched controls.


RESULTS
Hospital mortality in the study group was 84/126 (66.7%) vs. 118/7720 (1.5%) in the control population (P 1000 mL, chronic obstructive pulmonary disease and age.


CONCLUSIONS
This study confirms that the in-hospital mortality of patients requiring renal replacement therapy is high and shows a low long-term mortality with reasonable quality of life in patients discharged from hospital alive.
Landoni
G
G
Università Vita-Salute di Milano, IRCCS San Raffaele Hospital, Department of Cardiovascular Anaesthesia and Intensive Care, Italy. landoni.giovanni@hsr.it
Zangrillo
A
A
Franco
A
A
Aletti
G
G
Roberti
A
A
Calabrò
M G
MG
Slaviero
G
G
Bignami
E
E
Marino
G
G
D058186:Acute Kidney Injury / Q000601:surgery; D000758:Anesthesia; D006348:Cardiac Surgical Procedures / Q000401:mortality; D001026:Coronary Artery Bypass; D006334:Heart Function Tests; D006801:Humans; D016030:Kidney Transplantation / Q000502:physiology*; D007902:Length of Stay; D016343:Monitoring, Intraoperative; D011183:Postoperative Complications / Q000209:etiology / Q000628:therapy; D011788:Quality of Life; D012121:Respiration, Artificial; D012307:Risk Factors; D013534:Survival; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000209:etiology / Q000628:therapy