Cardiac surgery in patients with end-stage renal disease on dialysis

Figures & data

Table 1. Baseline characteristics of patients*.

Variable	Patients N = 136	Hemodialysis N = 99	Peritoneal Dialysis N = 30	p-value
Age (mean ± SD) yr	59.7 ± 12.9	59.4 ± 12.9	58.9 ± 13.7	.875
Sex Male (%)	106 (78)	77 (78)	23 (77)	.898
Hypertension (%)	98 (72)	76 (77)	19 (63)	.234
Hypercholesterolemia (%)	46 (33)	32 (33)	13 (43)	.434
Diabetes				.400
Diet (%)	7 (5)	6 (6)	0
NIDDM (%)	20 (15)	14 (14)	6 (20)
IDDM (%)	16 (12)	11 (11)	5 (16.7)
Smoking history (%)				.576
Smoker (%)	28 (21)	19 (19)	8 (27)
Ex-smoker (%)	28 (21)	24 (24)	4 (13)
Type of surgery				.336
CABG (%)	63 (46)	44 (44)	17 (57)
Valve (%)	40 (29)	30 (30)	9 (30)
Combined (%)	33 (24)	25 (25)	4 (13)
Acute surgery	15 (11)	12 (12)	2 (7)	.501
Preoperative Ejection Fraction %				.905
≥50 (%)	55 (40)	41 (41)	10 (33)
40–50 (%)	37 (27)	27 (27)	10 (33)
30–40 (%)	20 (15)	13 (13)	5 (17)
20–30 (%)	15 (11)	11 (11)	4 (13)
<20 (%)	4 (3)	3 (3)	1 (3)
EuroSCORE (mean ± SD)	8.57 ± 3.35	8.66 ± 3.31	8.03 ± 3.59	.379

*In 7 patients type of dialysis was not documented.

Table 2. Renal history/status of patients*.

VARIABLE	PATIENTS N = 136	Hemodialysis N = 99	Peritoneal Dialysis N = 30	p-value
Causes of renal failure				.481
Diabetic Nephropathy (%)	34 (25)	25 (25)	9 (30)
Hypertension (%)	26 (19)	20 (20)	6 (20)
Glomerulonephritis (%)	26 (19)	20 (20)	6 (20)
Chronic Nephritis (%)	4 (3)	4 (4)	0
Polycystic Kidney (%)	9 (7)	9 (9)	0
Chronic kidney disease (%)	5 (4)	4 (4)	1 (3)
Other (%)	27 (20)	15 (15)	8 (27)
History with a kidney transplantation**	20 (15)	16 (17)	2 (7)	.127
Time since initiation of dialysis (median, range) months	36 (1–396)	36 (1–336)	36 (2–396)	.667
Creatinine (mean ± SD) μmol/l	595 ± 239	562 ± 226	709 ± 260	.005

*In 7 patients type of dialysis was not documented.

**History of kidney transplantation, no graft function.

Table 3. Postoperative data*.

VARIABLE	PATIENTS N = 136	Hemodialysis N = 99	Peritoneal Dialysis N = 30	p-value
Days in ICU (median, range)	1 (1–48)	1 (1–40)	1 (1–48)	.580
Hospitalizations days (median, range)	8 (1–52)	8 (1–46)	10 (4–52)	.497
Complications
Re-operation (%)	20 (15)	16 (16)	4 (13)	.255
Pleurocentesis (%)	7 (5)	6 (6)	1 (3)	.563
Cardiac arrhythmia (%)	59 (43)	39 (39)	16 (53)	.176
Stroke (%)	11 (8)	8 (8)	0	.108
Prolonged ventilation (%)	25 (18)	18 (18)	4 (13)	.128
Sternal Infection (%)	7 (5)	3 (3)	3 (10)	.112
Multiple organ failure (%)	8 (6)	5 (5)	2 (7)	.813

*In 7 patients type of dialysis was not documented.

Figure 1. Mortality curve comparing hemodialysis and peritoneal dialysis. There was no statistical difference between the two groups (p = 0.713). (solid line hemodialysis, dashed line peritoneal dialysis).

Figure 2. Mortality curve comparing the surgical procedures. There were no statistical differences between the groups (p = 0.052). (dotted line CABG, solid line valve surgery and dashed line combined surgery) CABG = coronary artery bypass graft.