Nephron 2017 Apr 22
Effect of Prophylactic Dialysis on Morbidity and Mortality in Non-Dialysis-Dependent Patients after Coronary Artery Bypass Grafting: A Pilot Study.   
ABSTRACT
BACKGROUND/AIMS
Coronary artery bypass grafting (CABG) is associated with an increased risk of morbidity and mortality in patients with pre-existing renal dysfunction. Numerous measures have been implemented to overcome this problem; however, no improvement in outcomes has been achieved. This study was aimed at investigating the effects of prophylactic dialysis on mortality and morbidity in these patients.
METHODS
This randomized-controlled clinical trial enrolled 88 non-dialysis-dependent patients with chronic kidney disease awaiting CABG surgery. Thirty-nine randomly selected patients received dialysis 3 times prior to surgery, and 49 patients formed the control group. Kaplan-Meier analysis and Cox proportional-hazards models were used to identify factors associated with survival.
RESULTS
There was no significant difference in the development of morbidities between the groups (p = 0.413). A significant difference was evident in the average survival time (p = 0.037). Cox proportional-hazards models determined that the hazard ratio of death after surgery was 10.854-fold greater in non-dialysis patients than in patients who received dialysis (hazard ratio = 2).
CONCLUSION
Prophylactic dialysis prior to CABG decreases mortality, but does not affect morbidity, in patients with renal insufficiency.

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