Predictors of chronic kidney disease after coronary artery bypass grafting in patients with stable angina

Objective. To identify predictors of chronic kidney disease (CKD) after coronary artery bypass grafting (CABG) in patients with stable angina. Material and methods. The study included 66 patients with stable angina who underwent CABG without baseline CKD. Age of patients was 64±7 years, men comprised 80%. Of these, 97% of patients had arterial hypertension, 35% — diabetes mellitus, 30% — obesity grade 1 and 2, 6% — single-vessel coronary disease, 94% — multiple-vessel coronary disease, 36% — left main coronary artery stenosis >50%, 54% — previous myocardial infarction. On-pump CABG was performed in 73% of patients, bilateral LIMA grafting — in 48% of patients. CPB time was 65 (54—83) min, the number of grafts — 2.7±0.7. Acute kidney injury (AKI) was diagnosed according to KDIGO 2012 criteria, acute kidney disease (AKD) in 90 days after CABG — according to KDIGO 2022. CKD 6 months after CABG was defined by GFR<60 ml/min/1.73 m2. Results. After CABG, there were 11 (17%) cases of AKI, 8 (12%) cases of AKD and 12 (18%) cases of CKD in 8 (6—12) months after surgery. Age over 69±6 years, postoperative hyperglycemia >2.0 (1.0—4.0) days, in-hospital multiple organ failure (n=2, 17%) and AKD (n=7, 58%) were associated with CKD after CABG. The predictor of new cases of CKD after CABG was AKD. Cumulative annual incidence of cardiovascular complications (recurrent angina, death, hospitalizations due to unstable angina and emergency coronary artery stenting, decompensated heart failure requiring hospitalization) was higher in patients with CKD (33% vs 9%, p=0.028). Conclusion. The incidence of CKD after CABG was 18.2%. The predictor of CKD after CABG was AKD, which repeatedly increased the probability of CKD. Patients with CKD developed after CABG had an unfavorable annual cardiovascular prognosis.