title: The impact of non-dialysis-dependent renal dysfunction on outcome following cardiac surgery.
abstract: BACKGROUND
  We evaluated the results of different types of cardiovascular surgery in patients with chronic renal failure (CRF) (serum creatinine ≥2 mg/dL) who were not dialysis-dependent.
  
  
  METHODS
  Eighty-two patients who presented with non-dialysis-dependent CRF were retrospectively evaluated. Patients in Group 1 (n = 12) underwent valvular surgery, those in Group 2 (n = 58) underwent coronary artery bypass grafting (CABG), and those in Group 3 (n = 12) underwent combined CABG and valvular surgery.
  
  
  RESULTS
  The demographics were similar among the groups. Cardiopulmonary bypass and aortic cross-clamping times were shorter (P < .01), the use of blood and blood products was less, and the mechanical ventilation time and hospital stay were shorter in Group 2 in comparison to the other groups (P < .01). There were 4 (6.9%) early mortalities in Group 2. Late mortalities occurred in 4 (33.3%), 16 (27.6%), and 6 (50%) patients from Groups 1, 2, and 3, respectively. Cox regression analysis revealed that age, the presence of a preoperative cerebrovascular accident, the presence of a left main coronary lesion, preoperative blood urea nitrogen level, and the use of blood and blood products were independent risk factors for early mortality. High Euroscore, cerebrovascular accident, the use of platelet suspension, longer ventilation support times, and combined CABG and valvular surgery were independent risk factors for late mortality.
  
  
  CONCLUSIONS
  Morbidity and survival seemed to be more dependent on preoperative patient characteristics than the type of surgery in this group of patients. Combined CABG and valvular surgery was a risk factor for late mortality.
authors.affiliation: Department of Cardiovascular Surgery, Florence Nightingale Hospital, Abide-i Hurriyet Caddesi No: 164, Sisli, Istanbul, Turkey. bariscaynak@gmail.com
authors.forename: Barış
authors.initials: B
authors.lastname: Caynak
authors.forename: Zehra
authors.initials: Z
authors.lastname: Bayramoğlu
authors.forename: Burak
authors.initials: B
authors.lastname: Onan
authors.forename: Ismihan Selen
authors.initials: IS
authors.lastname: Onan
authors.forename: Ertan
authors.initials: E
authors.lastname: Sağbaş
authors.forename: Ilhan
authors.initials: I
authors.lastname: Sanisoğlu
authors.forename: Belhhan
authors.initials: B
authors.lastname: Akpınar
mesh_terms: D000368:Aged; D001806:Blood Urea Nitrogen; D006348:Cardiac Surgical Procedures; D003404:Creatinine / Q000378:metabolism*; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate / Q000502:physiology*; D006331:Heart Diseases / Q000150:complications / Q000453:epidemiology / Q000601:surgery*; D006801:Humans; D015994:Incidence; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000453:epidemiology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D006435:Renal Dialysis; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate / Q000639:trends; D014421:Turkey / Q000453:epidemiology
chemical_list: D003404:Creatinine