5.2 End-stage renal failure
It is demonstrated that a dose-dependent relationship exists between
increased severity of AKI and increased ESRD incidence among cardiac
surgery patients.31 Of note, small changes in
postoperative s-Cr levels resulted in up to a 4-fold increase in
long-term ESRD risk. A study by Ryden et al found that patients with
reduced preoperative eGFR are associated with a higher absolute risk of
ESRD after CABG procedure. Other known factors that predispose ESRD
development includes lower left ventricular ejection fraction, previous
stroke, myocardial infarction, and heart failure. 32Not only is diabetes mellitus is one of the principal causes of ESRD,
but the trajectory of ESRD is also rapid; within 5 years, among diabetic
patients who develop AKI postoperatively 33
Minimizing complications
Considering the significant renal complications associated with cardiac
surgeries, several clinical trials have been conducted in attempts to
manage risk factors appropriately and evaluate medical interventions, to
improve both short-term and long-term kidney
outcomes.41