May 18, 2012

Open Heart Surgery Options For Kidney Patients

(Ivanhoe Newswire )--Heart disease is not only the leading cause of death in the U.S, it´s also the top cause of death for people with chronic kidney disease (CKD). New research shows one type of open heart surgery is safer than another (in terms of both health and survival) for these patients.

Open heart surgery can be done two ways. The first way is off-pump. With this technique a surgeon can perform a bypass without stopping the heart. This may help cut down on kidney injuries that can happen after heart surgery. The second way is on-pump. Lakhmir Chawla, M.D., from George Washington University and his colleagues looked to see if off-pump bypass surgery helps protect the kidneys of CKD patients better than on-pump surgery.

For their research, the investigators studied more than 700,000 bypass surgery patients 21.4% of whom underwent off-pump surgery from 2004 to 2009. CKD patients with particularly poor kidney function were more than three times as likely to die or need dialysis during the study when they underwent on-pump surgery compared with off-pump surgery.

Patients with CKD often have heart problems, still they're usually excluded from heart bypass clinical trials and are often undertreated for heart disease.

"Our data suggest that excluding CKD patients from clinical trials of off-pump surgery may have resulted in an underestimation of potential benefit for this patient subgroup," Dr. Chawla was quoted as saying. "If you need to have bypass surgery and you have CKD, an operative approach that does not involve the heart-lung machine may help avoid the need for dialysis."

SOURCE: American Society of Nephrology, May 2012