Open heart surgery for kidney disease patients

May 17, 2012, American Society of Nephrology

One type of open heart surgery is likely safer than the other for chronic kidney disease (CKD) patients, according to a study appearing in an upcoming issue of the Journal of the American Society of Nephrology (JASN).

Open heart, or , surgery can be done two ways: on-pump or off-pump, depending on whether the patient is put on a heart-lung machine. Off-pump surgery allows a surgeon to perform a bypass without stopping the heart. This may help cut down on kidney injuries that can arise after heart surgery, which can deprive the kidneys of normal blood flow.

While patients with CKD often have , they're usually excluded from heart bypass clinical trials and are often undertreated for heart disease.

Lakhmir Chawla, MD (George Washington University) and his colleagues looked to see if off-pump bypass surgery helps protect the kidneys of CKD patients compared with on-pump surgery. The investigators studied 742,909 bypass surgery patients (158,561 or 21.4% of whom underwent off-pump surgery) from 2004 to 2009.

CKD patients with particularly poor were more than three times as likely to die or need dialysis during the study when they underwent on-pump surgery compared with off-pump surgery.

"Our data suggest that excluding CKD patients from clinical trials of off-pump surgery may have resulted in an underestimation of potential benefit for this patient subgroup," said Dr. Chawla. "If you need to have bypass surgery and you have CKD, an operative approach that does not involve the heart-lung machine may help avoid the need for dialysis," he added.

Explore further: Beating heart surgery may increase risk to patients

More information: The article, entitled "Off-Pump versus On-Pump CABG Outcomes Stratified by Pre-Operative Renal Function," will appear online on May 17, 2012, doi: 10.1681/ASN.2012020122

Related Stories

Beating heart surgery may increase risk to patients

March 14, 2012
Coronary artery bypass surgery performed whilst the heart is still beating may carry an increased likelihood of death, according to a systematic review by Cochrane researchers. The researchers suggest beating heart surgery ...

Largest study of on-pump and off-pump bypass proves both can be done safely

March 26, 2012
A large randomized trial comparing bypass surgery done with a heart-lung machine (on pump) and without it (off pump) found no differences in results between techniques overall but some clinically relevant differences, according ...

Recommended for you

Fresh approach to tuberculosis vaccine offers better protection

January 17, 2018
A unique platform that resulted in a promising HIV vaccine has also led to a new, highly effective vaccine against tuberculosis that is moving toward testing in humans.

Newly-discovered TB blood signal provides early warning for at-risk patients

January 17, 2018
Tuberculosis can be detected in people with HIV infection via a unique blood signal before symptoms appear, according to a new study by researchers from the Crick, Imperial College London and the University of Cape Town.

New study offers insights on genetic indicators of COPD risk

January 16, 2018
Researchers have discovered that genetic variations in the anatomy of the lungs could serve as indicators to help identify people who have low, but stable, lung function early in life, and those who are particularly at risk ...

Previous influenza virus exposures enhance susceptibility in another influenza pandemic

January 16, 2018
While past exposure to influenza A viruses often builds immunity to similar, and sometimes different, strains of the virus, Canadian researchers are calling for more attention to exceptions to that rule.

Don't hold your nose and close your mouth when you sneeze, doctors warn

January 15, 2018
Pinching your nose while clamping your mouth shut to contain a forceful sneeze isn't a good idea, warn doctors in the journal BMJ Case Reports.

New antifungal provides hope in fight against superbugs

January 12, 2018
Microscopic yeast have been wreaking havoc in hospitals around the world—creeping into catheters, ventilator tubes, and IV lines—and causing deadly invasive infection. One culprit species, Candida auris, is resistant ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.