title: [Cardiorenal prognosis in kidney dysfunction patients undergoing cardiac surgery].
abstract: OBJECTIVE
  To evaluate the impact of cardiac surgical procedures on cardiac and renal functions within 12 months after surgery in patients with a history of chronic kidney disease (CKD).
  
  
  METHODS
  A total of 875 patients (464 men and 411 women) aged 32 to 68 years (62.3±5.2 years), including 396 patients who had undergone heart valve replacement under extracorporeal circulation, 422 who had aortocoronary and/or mammary coronary artery bypass, and 57 who had a combination of these operations, were examined. According to the baseline glomerular filtration rate (GFR), the patients were divided into 2 groups: 1) 508 patients with preserved kidney function (GFR, higher than 90 ml/min/1.73 m2); 2) 367 with CKD (GFR, 89 to 60 ml/min/1.73 m2). Results. In Group 2, early postoperative cardiovascular events were noted significantly more frequently and mortality proved to be higher than in Group 1. By the end of the first year of a follow-up, CKD was diagnosed in 5.4% of the patients in Group 1. In Group 2, CKD regressed in 54.1 % of the patients and, on the contrary, progressed in 9.5%. In Group 2, programmed hemodialysis was performed in 15 (4.4%) patients. Overall mortality was significantly higher in patients with a postoperative glomerular filtration fall in both Groups 1 and 2 (7.5 and 8.4%, respectively). Long-term cardiovascular events were significantly more common in patients with progressive CKD and postoperative kidney dysfunction.
  
  
  CONCLUSIONS
  A slight decrease in glomerular filtration makes the immediate prognosis of cardiac surgery poorer. The late cardiorenal prognosis mainly depends on changes in kidney function; regression of CKD is noted in 50% of the cases.
authors.affiliation: Penza Institute for Postgraduate Training of Physicians, Ministry of Health of Russia, Penza, Russia.
authors.forename: B G
authors.initials: BG
authors.lastname: Iskenderov
authors.affiliation: Penza Institute for Postgraduate Training of Physicians, Ministry of Health of Russia, Penza, Russia.
authors.forename: O N
authors.initials: ON
authors.lastname: Sisina
mesh_terms: D000368:Aged; D001026:Coronary Artery Bypass / Q000009:adverse effects / Q000379:methods / Q000706:statistics & numerical data; D005260:Female; D005919:Glomerular Filtration Rate; D006331:Heart Diseases / Q000145:classification / Q000150:complications / Q000453:epidemiology / Q000601:surgery; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects / Q000379:methods / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis / Q000453:epidemiology; D011379:Prognosis; D006435:Renal Dialysis / Q000379:methods / Q000706:statistics & numerical data*; D051436:Renal Insufficiency, Chronic / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D012307:Risk Factors; D012426:Russia / Q000453:epidemiology; D012720:Severity of Illness Index