Online ISSN: 2515-8260

Keywords : Renal dysfunction


Impact of preoperative renal dysfuntion on short-term outcomes of patients undergoing off-pump coronary artery bypass grafting

Prerna Singh, Mayank Swarnkar, Saraansh Bansal, Dr. G. Ramasubrahmanium

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 11983-11992

Aim: To study the incidence and clinical profile of post-operative acute kidney injury in patients undergoing cardiac surgery.
Materials and Methods: The present prospective descriptive study was conducted at a tertiary care hospital in South India, for the period of 2 years (Jan 2017-Dec 2019) to compare post-operative outcomes in patients with normal and varying degrees of non-dialysis dependant renal insufficiency (NRDI) in patients undergoing off pump Coronary Artery Bypass Grafting (OPCABG). All the patients were categorized into five groups/stages by glomerular filtration rate (GFR). All the relevant data was captured for all patients in the study specific case report forms. At the time of admission to the operation baseline clinical characteristics such as age, sex, obesity, smoking, New York Heart Association (NYHA) class, previous myocardial infarction (MI), percutaneous coronary intervention (PCI), diabetes mellitus (DM), hypertension, hyperlipidaemia, chronic obstructive pulmonary disease (COPD), Left ventricular ejection fraction (LVEF), prior CVA, eGFR, serum creatinine, anatomical severity of coronary artery disease (CAD). Operative data like number of grafts, type of conduit, target artery and postoperative details such as major adverse cardiac cerebrovascular events were collected.
Results: Patients in severe group showed higher rates of comorbidities when compared with mild, moderate and normal groups. Mean number of grafts used were similar between the groups (p=0.49). Even though percentage of re-exploration for bleeding did not show any significant difference (p=0.40) among the group, patients in severe group showed high percentage of re-explorations.
Conclusion: There was no significant difference in the patients undergoing off-pump CABG with normal, mild, moderate and severe renal functions in terms of short-term mortality. Off-pump CABG is more reno-protective for patients with normal renal function.

PREDICTION OF THE DEVELOPMENT OF RENAL DYSFUNCTION IN PATIENTS WITH CHRONIC HEART FAILURE

Kamilova Umida; Nuritdinov Nuriddin; Zakirova Gulnoza

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 2, Pages 1368-1374

Purpose. To identify prognostic factors for the development of renal dysfunction (RD) and to develop a method for
assessing and predicting RD in patients with chronic heart failure (CHF).
Methods. A total of 101 patients with functional class I-III (FC) CHF (according to the classification of the New
York Heart Association) were examined. Also, the patients were divided, depending on the glomerular filtration
rate, determined by the calculation method according to the CKD-EPI formula (eGFR), into two groups: patients
with eGFR≥90 ml / min (n = 20), with eGFR <90 ml / min (n = 81). All patients were determined: creatinine (Cr),
eGFR according to the CKD-EPI formula, albumin / creatinine (Al / Cr) level (mg / mmol) in morning urine,
specific gravity in morning urine portion (SG); studied renal blood flow according to Doppler sonography at the
level of the common left and right renal arteries. To assess the significance of signs for determining and predicting
RD in CHF, we used a method based on Wald's sequential statistical analysis with the development of differential
diagnostic tables, determination of diagnostic coefficients (DC) and information content (J) of each sign in groups of
patients with CHF, depending on the level eGFR, determination of diagnostic thresholds (amount of DC).
Results. As a result of the developed differential diagnostic tables, the most informative signs were identified that
determine the unfavorable prognosis of RD in patients with CHF: creatinine above 80 μmol / l, eGFR less than 90
ml / min, Al / Cr ratio in morning urine more than 3.4 mg / mmol, urine specific gravity SG less than 1015,
resistance index (RI) at the level of the right and left renal arteries more than 0.7. The sum of DCs of these signs,
depending on the severity of symptoms, determines the risk of developing RD: a very high risk in the range from
+15 to +32, high risk - from +8 to +14, moderate risk - from +7 to +3, favorable course of CHF - from 0 to +2
points.
Conclusion. Signs of an unfavorable prognosis for the development of RD in patients with CHF were determined:
creatinine above 80 μmol / l, eGFR less than 90 ml / min, Al / Cr ratio in morning urine more than 3.4 mg / mmol, urine SG less than 1015, RI at the renal level arteries more than 0.7.

Impact Of Chronic Heart Failure On Comorbidities In Hot Climates On The Quality Of Life And Clinical Condition Of Patients

Tosheva Kh.; Xalilova F.; Gadaev A; Erkinova N.; Djuraeva N.

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 10, Pages 1080-1089

It is well known that one of the leading causes of death among the population is cardiovascular disease, and they are often complicated by CHF.
In European countries, the prevalence of CHF is 2.1%, with 90% of women over the age of 70 and 75% of men. In the United States, these numbers range from 1–1.5% and occur in 10% of the population over the age of 60.
According to a number of leading researchers around the world, the inclusion of concomitant diseases in CHF not only worsens its overall outcome, increases the number and duration of hospital treatments , but in some cases is also the leading cause of death. Some authors compare the dynamics of deaths observed in CHF with deaths due to oncological diseases.