Risk factors for deterioration of renal function after coronary artery bypass grafting.
OBJECTIVE
Various definitions of impairment of renal function after coronary artery bypass grafting (CABG) are used in the literature. Depending on the definition, several risk factors are identified. We analysed our data to determine the risk factors for postoperative deterioration of the creatinine clearance of 10% or more.


METHODS
All patients undergoing isolated coronary surgery in a single centre between January 1998 and December 2007 are included. Clinical data, including demographics and renal risk factors, were prospectively collected in our database. The most recent preoperative serum creatinine level and the maximum serum creatinine level within the first week postoperatively were used to calculate the creatinine clearance. A deterioration of 10% or more was considered to be an endpoint for this study.


RESULTS
In 10098 out of a total of 10626 patients, the preoperative as well as the postoperative creatinine clearance could be calculated. In 1053 patients, the deterioration of the creatinine clearance was 10% or more. We could identify the following risk factors: advanced age, diabetes, chronic obstructive pulmonary disease, peripheral vascular disease, emergency operation, previous cardiac surgery, low preoperative haemoglobin level, high preoperative C-reactive protein level, perioperative myocardial infarction, re-exploration and the number of blood transfusions.


CONCLUSIONS
Risk factors for the deterioration of renal function after revascularisation have been confirmed in this study. In addition, we found peripheral vascular disease, previous cardiac surgery, low preoperative haemoglobin, increased preoperative C-reactive protein level, perioperative myocardial infarction and the number of blood transfusions to be risk factors that have not been described earlier.
van Straten
Albert H M
AH
Department of Cardio-Thoracic Surgery, Catharina Hospital, Eindhoven, The Netherlands.
Hamad
Mohamed A Soliman
MA
van Zundert
André A A J
AA
Martens
Elisabeth J
EJ
Schönberger
Jacques P A M
JP
de Wolf
Andre M
AM
D000367:Age Factors; D000368:Aged; D015415:Biomarkers / Q000097:blood; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000378:metabolism; D001026:Coronary Artery Bypass / Q000009:adverse effects*; D003404:Creatinine / Q000097:blood; D048909:Diabetes Complications / Q000503:physiopathology; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D007668:Kidney / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D016491:Peripheral Vascular Diseases / Q000503:physiopathology; D029424:Pulmonary Disease, Chronic Obstructive / Q000503:physiopathology
D015415:Biomarkers; D002097:C-Reactive Protein; D003404:Creatinine