Perioperative and mid-term prognosis in coronary artery bypass grafting patients with mild renal dysfunction

Abstract

Objective: Renal dysfunction is the most common risk factor for patients with coronary artery bypass grafting (CABG). The aim of this research was to evaluate the prognosis and mid-term outcomes in CABG patients with mild renal dysfunction. Methods: Patients undergoing isolated CABG from July 2020 to December 2022 in Nanjing First Hospital were selected into this cohort study and divided into normal renal function group (eGFR ≥ 90 mL/min/1.73 m2, corresponding to CKD G1) and mild renal dysfunction group (eGFR: 60–89 mL/min/1.73 m2, corresponding to CKD G2). Propensity score matching was used to balance the differences. The primary outcomes were acute kidney injury (AKI) and all-cause mortality in follow-up, while the secondary outcomes were perioperative mortality and major adverse cardiac and cerebrovascular event (MACCE) including death, stroke, myocardial infarction, and revascularization. Results: Totally 1,097 patients were enrolled in this study and 416 (33.3%) had mild renal dysfunction. A total of 379 pairs were included to the analysis after propensity score matching. Compared with the normal renal function, patients with mild renal dysfunction had more AKI after CABG (26.1% vs. 18.7%, p = 0.015), however, the perioperative mortality (1.3% vs. 1.3%, p = 1.00) was not significantly different. At 3-year follow-up, there were also no significant differences in all-cause mortality (6.3% vs. 4.8%, log-rank p = 0.33, HR 1.38, 95%CI: 0.721–2.652) and MACCE rates (10.2% vs. 7.6%, log-rank p = 0.19, HR 1.42, 95%CI: 0.836–2.414). Conclusion: For patients undergoing CABG, preoperative renal dysfunction is associated with an increased risk of postoperative AKI. However, no significant difference was observed in perioperative mortality and mid-term outcomes.