Determinants of the Renal Function After the Coronary Artery Bypass Grafting in Chronic Kidney Disease Patients: A Prospective Cohort Study Publisher Pubmed



Nooralishahi B ; Rahmanian M ; Samavat S ; Jafari K ; Nafar M ; Dalili N ; Baratali B H ; Khademi R ; Jafari M ; Ghotbein R
Source: Journal of cardiothoracic surgery Published:2026

Abstract

BACKGROUND: This study aims to evaluate renal outcomes and identify key factors influencing estimated glomerular filtration rate (eGFR) in patients with chronic kidney disease(CKD) undergoing coronary artery bypass grafting (CABG). METHODS: In a prospective cohort of 100 patients with CKD (mean age 65.5 years; 77% male; most in CKD stage 2 or 3), eGFR was measured at baseline, three months, and six months postoperatively. Generalized Estimating Equations (GEE) were applied to assess longitudinal changes in eGFR and associated predictors. Statistical analyses were performed using Stata 17. RESULTS: Approximately 19% of patients experienced a > 30% decline in eGFR, while over 40% demonstrated improvement at six months. Advanced CKD stage, higher preoperative heart ejection fraction (EF), and longer anesthesia time were associated with greater eGFR decline. Conversely, higher preoperative hemoglobin (Hb) levels, elective surgery, and a history of cerebrovascular accident were associated with improved estimated eGFR trends. CONCLUSION: Several clinical and procedural factors influence postoperative renal function in CKD patients undergoing CABG. These findings support the development of targeted perioperative strategies to mitigate renal decline. CLINICAL TRIAL REGISTRATION: This study does not meet the criteria of a clinical trial and, therefore, was not registered in a clinical trial registry.