title: Does the preoperative mild renal dysfunction effect mortality and morbidity following valve cardiac surgery?
abstract: OBJECTIVE
  The objective of this study was to investigate the effect of preoperative mild renal dysfunction (RD), not requiring dialysis, on mortality and morbidity after valve cardiac surgery (VCS).
  
  
  METHODS
  We studied 340 consecutive patients (2008-2012), who underwent VCS with or without coronary artery bypass graft (CABG).
  
  
  METHODS
  Preoperative RD was calculated with the abbreviated Modification of Diet in Renal Disease formula and was defined as a glomerular filtration rate <60ml/min/1.73m(2). Logistic regression analysis was used to assess the effect of preoperative renal dysfunction (RD) on operative and adverse outcomes.
  
  
  RESULTS
  80 patients (30%) had preoperative mild RD. Patients with preoperative RD were older, had a higher rate of preoperative anemia (43% vs. 25%, p<0.001), and more comorbidities. Patients with preoperative RD had worse outcomes with more reoperation (6.8% vs. 2.3%, p<0.001).
  
  
  CONCLUSIONS
  Preoperative RD was significantly and independently associated with more red blood cell transfusions and longer hospital stay (median 9 vs. 8 days, p<0.001). Mortality was similar in both groups (3.4% vs. 2.3%, p=0.43). Preoperative mild RD in patients undergoing cardiac valve surgery is an independent marker of postoperative morbidity.
authors.affiliation: Postgraduate Student (MSc.), Department Of Surgery, Faculty of Medicine, University of Aleppo, Syria. Electronic address: hadyaboaljadayel@yahoo.com.
authors.forename: Hadi Abo
authors.initials: HA
authors.lastname: Aljadayel
authors.affiliation: Department of Surgery, Faculty of Medicine, University of Aleppo, Syria.
authors.forename: Hussein
authors.initials: H
authors.lastname: AlKanj
authors.affiliation: Department of Surgery, Faculty of Medicine, University of Aleppo, Syria.
authors.forename: Salah
authors.initials: S
authors.lastname: Koja
authors.affiliation: Department of Surgery, Faculty of Medicine, University of Aleppo, Syria.
authors.forename: Fadi
authors.initials: F
authors.lastname: Butruss
mesh_terms: D000368:Aged; D003404:Creatinine / Q000097:blood*; D005260:Female; D005919:Glomerular Filtration Rate / Q000502:physiology*; D006349:Heart Valve Diseases / Q000150:complications / Q000601:surgery*; D019918:Heart Valve Prosthesis Implantation; D017052:Hospital Mortality / Q000639:trends; D006801:Humans; D007668:Kidney / Q000503:physiopathology*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009017:Morbidity / Q000639:trends; D011184:Postoperative Period; D057234:Preoperative Period; D051437:Renal Insufficiency / Q000097:blood / Q000150:complications / Q000503:physiopathology*; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate / Q000639:trends; D013593:Syria / Q000453:epidemiology
chemical_list: D003404:Creatinine
keywords: Morbidity; Mortality; Preoperative renal dysfunction; Valve cardiac surgery