Ahmad Zuhdi, Mamat
(2010)
The effects of renal dysfunction on patients undergoing
coronary artery bypass grafting in Hospital Universiti
Sains Malaysia.
Masters thesis, Universiti Sains Malaysia.
Abstract
Chronic kidney disease (CKJD) has been known to be a potent risk
factor for cardiovascular death. It has been implicated in the adverse outcomes seen in
patients after their coronary artery bypass grafting (CABG). The aim of this study is
to evaluate the relation between renal dysfunction and the morbidity and mortality
following CABG. Hospital, Kubang Kerian were collected. These patients were divided into 2 groups,
according to their estimated glomerular filtration rate (GFR) using the Cockcroft-
Gault formula. Estimated GFR of less than 60 ml/min were grouped into the renal
dysfunction, whilst GFR >60ml/min were grouped as non-renal dysfunction. These
retrospective data were analysed for its demographic and outcomes after the
procedure, including the short and long term mortality rates.
Results: All the 215 records representing 215 patients were successfully collected
and analysed. 117 (54.4%) patients had estimated GFR <60 ml/min and labelled as
renal dysfunction group. This group of patient had a significantly lower body mass
index, poorer pre-operative ejection fraction and was older. There were also more
incidences of diabetes mellitus and hypertension within this group (p=0.005 and
0.031). Intra-operative data showed that the renal dysfunction group had shorter cross-clamp time (p=0.018) and used up less cardioplegia (p=0.004) during the
bypass. Post-operative data analysis showed that the patients with renal dysfunction
had more chance of developing acute renal failure (p<0.001) and arrhythmia
(p=0.047). A total 10 patients who died within 30 days and 15 patients died within 3
years of CABG, but there was no significant difference noted between these 2 groups.
Conclusion: This study supported the evidences that pre-operative renal dysfunction,
acute renal failure and arrhythmia. The relation between renal dysfunction and postoperative
mortalities was however failed to be demonstrated in this study, as
compared to many other studies before.
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