Abstract
Purpose We examined the association between chronic kidney disease (CKD) and postoperative cognitive dysfunction (POCD) in patients undergoing coronary artery bypass grafting.
Methods Data were collected on 315 patients. They were divided into three groups according to the severity of CKD, as determined from glomerular filtration rate (eGFR): >60 (n=137), 30~60 (n=145), <30 ml/min/1.73 m2 (n=33). Four cognitive tests were performed preoperatively and 1 week after surgery. POCD was defined as a decrease of at least 20% from baseline in performance on more than one test.
Results Risk factors and the degree of craniocervical and aortic atherosclerosis were similar for the three groups. Except the percentage of patients with severe white matter lesions (WML) increased with lower eGFR (respectively 28%, 34%, 45%) and the incidences of POCD were 40%, 50%, 64%, respectively (P<0.05). Multivariate analysis revealed that 7 factors were correlated with POCD: male, age, cervical atherosclerosis, lower educational level, preoperative cognitive decline, WML and CKD.
Conclusion Patients with CKD are at higher risk for POCD due to their high prevalence of WML.
