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01-11-2011 | Original Article

Which method of estimating renal function is the best predictor of mortality after coronary artery bypass grafting?

Auteurs: A. H. M. van Straten, M. A. Soliman Hamad, B. M. J. A. Koene, E. J. Martens, M. E. S. H. Tan, E. Berreklouw, A. A. J. van Zundert

Gepubliceerd in: Netherlands Heart Journal | Uitgave 11/2011

Abstract

Objectives

Definitions of renal function in patients undergoing coronary artery bypass graft surgery (CABG) vary in the literature. We sought to investigate which method of estimating renal function is the best predictor of mortality after CABG.

Methods

We analysed the preoperative and postoperative renal function data from all patients undergoing isolated CABG from January 1998 through December 2007. Preoperative and postoperative renal function was estimated using serum creatinine (SeCr) levels, creatinine clearance (CrCl) determined by the Cockcroft-Gault formula and the glomerular filtration rate (e-GFR) estimated by the Modification of Diet in Renal Disease (MDRD) formula. Receiver operator characteristic (ROC) curves and area under the ROC curves were calculated.

Results

In 9987 patients, CrCl had the best discriminatory power to predict early as well as late mortality, followed by e-GFR and finally SeCr. The odds ratios for preoperative parameters for early mortality were closer to 1 than those of the postoperative parameters.

Conclusions

Renal function determined by the Cockcroft-Gault formula is the best predictor of early and late mortality after CABG. The relationship between renal function and mortality is non-linear. Renal function as a variable in risk scoring systems such as the EuroSCORE needs to be reconsidered.

vorige artikel National differences in screening programmes for cardiovascular risks could obstruct understanding of cardiovascular prevention studies in Europe

volgende artikel Clinical and scientific progress related to the interface between cardiology and psychology: lessons learned from 35 years of experience at the Thoraxcenter of the Erasmus Medical Center in Rotterdam

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Titel: Which method of estimating renal function is the best predictor of mortality after coronary artery bypass grafting?
Auteurs: A. H. M. van Straten
M. A. Soliman Hamad
B. M. J. A. Koene
E. J. Martens
M. E. S. H. Tan
E. Berreklouw
A. A. J. van Zundert
Publicatiedatum: 01-11-2011
Uitgeverij: Bohn Stafleu van Loghum
Gepubliceerd in: Netherlands Heart Journal / Uitgave 11/2011
Print ISSN: 1568-5888
Elektronisch ISSN: 1876-6250
DOI: https://doi.org/10.1007/s12471-011-0184-3

Bohn Stafleu van Loghum

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Abstract

Objectives

Methods

Results

Conclusions

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