Scholarlink

Background <p>Preoperative occult renal dysfunction (PORD), defined as a normal serum creatinine (Scr) level with glomerular filtration rate (eGFR) &lt; 60 mL/min/1.73&#xa0;m², may worsen outcomes after cardiac surgery. This study aimed to evaluate whether PORD is associated with adverse short- and long-term outcomes in elderly patients undergoing coronary artery bypass grafting (CABG).</p> Methods <p>A retrospective analysis was conducted in 1,157 patients aged ≥ 70 years with normal Scr who underwent CABG at four centers. Patients were classified into PORD and control groups according to eGFR. Propensity score matching was used to balance preoperative characteristics. Logistic regression was performed to identify risk factors for postoperative acute kidney injury (AKI) and in-hospital mortality. Long-term survival was assessed using Kaplan–Meier analysis and Cox proportional hazards models.</p> Results <p>PORD was present in 29.3% of elderly patients with normal Scr. Compared with controls, the PORD group had higher preoperative Scr, higher rates of postoperative AKI (33.33% vs. 14.30%), and higher in-hospital mortality (6.19% vs. 3.55%). PORD independently predicted postoperative AKI and in-hospital mortality, and was associated with increased long-term mortality after CABG.</p> Conclusions <p>Nearly one-third of elderly CABG patients with normal Scr have PORD, which is associated with a higher risk of postoperative AKI, in-hospital death, and long-term mortality. Routine eGFR assessment is recommended to improve preoperative renal risk stratification in this population.</p> Clinical trial number <p>Not applicable.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Impact of occult renal dysfunction on postoperative acute kidney injury and late prognosis in elderly patients undergoing coronary artery bypass

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年1月28日

查看全文
  • Zhonghe Liu,
  • Kai Xu,
  • Chong Zhang,
  • Mingliang Li,
  • Yangyang Sun,
  • Yilin Pan,
  • Wanyue Dong,
  • Lixiang Han,
  • Zihua Liu,
  • Wenqi Li,
  • Xin Zhao,
  • Xudong Liu,
  • Zhi Li,
  • Yangyang Zhang

摘要

Background

Preoperative occult renal dysfunction (PORD), defined as a normal serum creatinine (Scr) level with glomerular filtration rate (eGFR) < 60 mL/min/1.73 m², may worsen outcomes after cardiac surgery. This study aimed to evaluate whether PORD is associated with adverse short- and long-term outcomes in elderly patients undergoing coronary artery bypass grafting (CABG).

Methods

A retrospective analysis was conducted in 1,157 patients aged ≥ 70 years with normal Scr who underwent CABG at four centers. Patients were classified into PORD and control groups according to eGFR. Propensity score matching was used to balance preoperative characteristics. Logistic regression was performed to identify risk factors for postoperative acute kidney injury (AKI) and in-hospital mortality. Long-term survival was assessed using Kaplan–Meier analysis and Cox proportional hazards models.

Results

PORD was present in 29.3% of elderly patients with normal Scr. Compared with controls, the PORD group had higher preoperative Scr, higher rates of postoperative AKI (33.33% vs. 14.30%), and higher in-hospital mortality (6.19% vs. 3.55%). PORD independently predicted postoperative AKI and in-hospital mortality, and was associated with increased long-term mortality after CABG.

Conclusions

Nearly one-third of elderly CABG patients with normal Scr have PORD, which is associated with a higher risk of postoperative AKI, in-hospital death, and long-term mortality. Routine eGFR assessment is recommended to improve preoperative renal risk stratification in this population.

Clinical trial number

Not applicable.