| Sub-title | |
| Author | A Manche |
| Abstract | Introduction: Renal replacement therapy may become necessary after cardiac surgery. An important risk factor for this development is preoperative renal impairment that is more prevalent with increasing age. Over the past 12 years the percentage of patients over 70 undergoing cardiac surgery has increased from 21% to 30%. Our use of dialysis has increased from 1% to 7% over this period. The timing of dialysis after surgery is crucial to the outcome of these patients Aim: To determine the optimum timing of dialysis in acute renal failure after cardiac surgery. Methods: A retrospective analysis was made of our changing practice in this field. Results: In the first 6 years of this series (phase 1) only 3 (19%) of the 16 patients who underwent dialysis were discharged from hospital. During the latter 5.5 years (phase 2) 38 (73%) of the 52 patients who underwent dialysis survived. In phase 2 we used dialysis in the early phase of acute renal failure after cardiac surgery, when oliguria set in, and before the metabolic consequences of renal shutdown occurred. Conclusion: We believe this protocol of early dialysis was responsible for our improved results and also enabled us to accept more patients with renal impairment for surgery. |
Published in: | |
| Journal | Malta Medical Journal |
| Volume | 18 Supplement |
| Page | |
| Date | 01/12/2006 |
| Link to journal | |
| Key words | cardiac surgery, dialysis |