PMID- 31016958
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220410
IS  - 2211-9132 (Print)
IS  - 2211-9140 (Electronic)
IS  - 2211-9132 (Linking)
VI  - 38
IP  - 3
DP  - 2019 Sep 30
TI  - Outcomes of open heart surgery in patients with end-stage renal disease.
PG  - 399-406
LID - 10.23876/j.krcp.18.0123 [doi]
AB  - BACKGROUND: Cardiovascular diseases of chronic dialysis patients are often 
      undertreated because of their higher surgical risk. This study aimed to assess 
      mortality and morbidity after open heart surgery in chronic dialysis patients 
      compared to those with normal renal function and identify risk factors for 
      postoperative outcomes. METHODS: We retrospectively analyzed 2,432 patients who 
      underwent open heart surgery from 2002 to 2017 and collected data from 116 
      patients (38 patients on dialysis and 78 age-, sex-, and diabetes mellitus 
      status-matched control patients with normal kidney function). We assessed 
      comorbidities, New York Heart Association (NYHA) class, laboratory data, surgical 
      methods, and postoperative outcomes. RESULTS: The dialysis group had more 
      comorbidities, higher NYHA classes, and greater need for urgent surgeries 
      compared to the control group. They exhibited significantly higher postoperative 
      mortality (18.4% vs. 2.6%, P = 0.005) and more overall complications (65.8% vs. 
      25.6%, P < 0.001). Dialysis itself significantly increased relative risk for 
      inhospital mortality after adjustment. EuroSCORE II was not as useful as in the 
      general population. Multivariate logistic regression analysis demonstrated that 
      total (adjusted odds ratio [AOR], 10.7; P = 0.029) and in-hospital death risk 
      (AOR, 14.7; P = 0.033), the durations of postoperative hospitalization (AOR, 4.6; 
      P = 0.034), CRRT (AOR 36.8; P = 0.004), and ventilator use (AOR, 7.6; P = 0.022) 
      were significantly increased in the dialysis group. CONCLUSION: The dialysis 
      group exhibited a higher risk for mortality and overcall complications after open 
      heart surgery compared to the patients with normal renal function. Therefore, the 
      benefit of surgical treatment must be balanced against potential risks.
FAU - Park, Jung Hwa
AU  - Park JH
AUID- ORCID: 0000-0002-3337-5082
AD  - Division of Nephrology, Department of Internal Medicine, Kyungpook National 
      University School of Medicine, Daegu, Korea.
FAU - Lim, Jeong-Hoon
AU  - Lim JH
AUID- ORCID: 0000-0001-5517-9886
AD  - Division of Nephrology, Department of Internal Medicine, Kyungpook National 
      University School of Medicine, Daegu, Korea.
FAU - Lee, Kyung Hee
AU  - Lee KH
AUID- ORCID: 0000-0003-0046-6604
AD  - Division of Nephrology, Department of Internal Medicine, Kyungpook National 
      University School of Medicine, Daegu, Korea.
FAU - Jung, Hee-Yeon
AU  - Jung HY
AUID- ORCID: 0000-0003-0232-7202
AD  - Division of Nephrology, Department of Internal Medicine, Kyungpook National 
      University School of Medicine, Daegu, Korea.
FAU - Choi, Ji-Young
AU  - Choi JY
AUID- ORCID: 0000-0002-9774-3665
AD  - Division of Nephrology, Department of Internal Medicine, Kyungpook National 
      University School of Medicine, Daegu, Korea.
FAU - Cho, Jang-Hee
AU  - Cho JH
AUID- ORCID: 0000-0002-7031-5214
AD  - Division of Nephrology, Department of Internal Medicine, Kyungpook National 
      University School of Medicine, Daegu, Korea.
FAU - Kim, Chan-Duck
AU  - Kim CD
AUID- ORCID: 0000-0002-4648-0324
AD  - Division of Nephrology, Department of Internal Medicine, Kyungpook National 
      University School of Medicine, Daegu, Korea.
FAU - Kim, Yong-Lim
AU  - Kim YL
AUID- ORCID: 0000-0002-1344-3455
AD  - Division of Nephrology, Department of Internal Medicine, Kyungpook National 
      University School of Medicine, Daegu, Korea.
FAU - Jung, Hanna
AU  - Jung H
AUID- ORCID: 0000-0002-2070-3980
AD  - Department of Thoracic and Cardiovascular Surgery, Kyungpook National University 
      School of Medicine, Daegu, Korea.
FAU - Kim, Gun Jik
AU  - Kim GJ
AUID- ORCID: 0000-0002-8051-2131
AD  - Department of Thoracic and Cardiovascular Surgery, Kyungpook National University 
      School of Medicine, Daegu, Korea.
FAU - Park, Sun-Hee
AU  - Park SH
AUID- ORCID: 0000-0002-0953-3343
AD  - Division of Nephrology, Department of Internal Medicine, Kyungpook National 
      University School of Medicine, Daegu, Korea.
LA  - eng
PT  - Journal Article
PL  - Korea (South)
TA  - Kidney Res Clin Pract
JT  - Kidney research and clinical practice
JID - 101586778
PMC - PMC6727895
OTO - NOTNLM
OT  - Cardiovascular disease
OT  - Dialysis
OT  - Renal insufficiency
OT  - Thoracic surgery
COIS- Conflicts of interest All authors have no conflicts of interest to declare.
EDAT- 2019/04/25 06:00
MHDA- 2019/04/25 06:01
PMCR- 2019/09/01
CRDT- 2019/04/25 06:00
PHST- 2018/10/02 00:00 [received]
PHST- 2019/03/15 00:00 [revised]
PHST- 2019/03/19 00:00 [accepted]
PHST- 2019/04/25 06:00 [pubmed]
PHST- 2019/04/25 06:01 [medline]
PHST- 2019/04/25 06:00 [entrez]
PHST- 2019/09/01 00:00 [pmc-release]
AID - j.krcp.18.0123 [pii]
AID - krcp-38-399 [pii]
AID - 10.23876/j.krcp.18.0123 [doi]
PST - ppublish
SO  - Kidney Res Clin Pract. 2019 Sep 30;38(3):399-406. doi: 10.23876/j.krcp.18.0123.