2020 年 26 巻 3 号 p. 48-56
Aim: We investigated the Results of coronary artery bypass grafting (CABG) performed on non-dialysis patients with renal dysfunction at our hospital. Methods: Fourteen hundred and eighty-two patients who underwent isolated CABG between January 2007 and December 2018 were classified into 3 groups: C-group (544 non-dialysis patients with stage 3a-5 chronic kidney disease [CKD]); N-group (785 patients with stage 1-2 CKD identified as those with normal renal function); and H-group (153 hemodialysis patients). A propensity score matching was performed, we compared 1050 cases of the matched 525 cases between the C-group and the N-group, and 264 cases of 132 cases between C- group and H-group, respectively. Results: In surgical mortality, no significant difference was observed between the C-group and the N-group/the H-group and even after matching. In hospital mortality rate, the C-group was significantly higher than the N-group (p=0.002), but there was no significant difference between the C-group and the H-group (p=0.122). After the matching, in-hospital mortality was significantly higher than in N-group (p=0.014) and significantly lower than in H-group (p=0.019). In long-term postoperative results, the C-group was worse than the N-group, but better than the H-group and even after matching. The survival rates in descending order by CKD stage were N-group, stage 3a, stage 3b, and stage 4/stage 5/H-group, with a significant difference. The long-term postoperative survival rates in stage 4, stage 5, and H-group were all equivalent. Conclusion: There was no significant difference in surgical mortality from C-group compared with N-group or H-group. In long-term postoperative outcomes, the C-group was worse than the N-group, but better than the H-group. However, the long term result of CKD stage 4 and 5 may have poor results comparable to those in the dialysis patients.