Long-term outcome of patients who require renal replacement therapy after cardiac surgery

G. Landoni, A. Zangrillo, A. Franco, G. Aletti, A. Roberti, M. G. Calabrò, G. Slaviero, E. Bignami, G. Marino

Research output: Contribution to journalArticle

Abstract

Background and objective: Acute renal failure is a serious complication of cardiac surgery. We studied the long-term survival and quality of life of patients requiring renal replacement therapy after cardiac surgery, since they represent a heavy burden on hospital resources and their outcome has never been adequately evaluated. Methods: Out of 7846 consecutive cardiac surgical patients, 126 (1.6%) required postoperative renal replacement therapy: their preoperative status and hospital course was compared with patients who had no need of postoperative renal replacement therapy. A multivariate analysis identified predictors of renal replacement therapy. Long-term survival and quality of life was collected in patients who had renal replacement therapy and in case-matched controls. Results: Hospital mortality in the study group was 84/126 (66.7%) vs. 118/7720 (1.5%) in the control population (P <0.001). Patients who underwent renal replacement therapy and were discharged from the hospital (42 patients) had a reasonable long-term outcome: at 42 ± 23 months, 30 out of 42 patients were alive, with only 3 patients complaining of limitations in daily activities. Predictors of in-hospital renal replacement therapy were: emergency surgery, preoperative renal impairment, intra-aortic balloon pumping, reoperation for bleeding, previous cardiac surgery, female gender, low ejection fraction, bleeding >1000 mL, chronic obstructive pulmonary disease and age. Conclusions: This study confirms that the in-hospital mortality of patients requiring renal replacement therapy is high and shows a low long-term mortality with reasonable quality of life in patients discharged from hospital alive.

Original languageEnglish
Pages (from-to)17-22
Number of pages6
JournalEuropean Journal of Anaesthesiology
Volume23
Issue number1
DOIs
Publication statusPublished - Jan 2006

Keywords

  • Cardiac surgical procedures
  • Hospital mortality
  • Kidney failure acute
  • Mortality
  • Renal replacement therapy

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

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