Successful treatment of 54 patients with acute renal failure after cardiac surgery

Objectives　To evaluate the result of treatment of acute renal failure (ARF) in patients after cardiac surgery. Methods　The clinical data of 54 cases admitted to the hospital from Jan. 2004 to Jan. 2014 and suffered from ARF after cardiac surgery were retrospectively analyzed. Among 54 cases, there were 35 males and 19 females, aged from one month to 79 years with a median of 52 years. The surgical procedures included coronary artery bypass grafting (CABG, 10 cases), valve surgery (22 cases), combined CABG and valve surgery (4 cases), operation on aorta (14 case), and radical correction of Fallot tetralogy (4 cases). After the operations mentioned above, 50 patients received continuous renal replacement therapy (CRRT), and 4 patients received peritoneal dialysis. Results　Nine patients died, the mortality rate was 16.7%. Exploratory hemostasis by thoracotomy was performed in 8 patients, and extubation failure occurred in 4 cases. Of the 9 non-survivors, 6 died from multiple organ failure (MOF), 2 died from cerebral hemorrhage, and one died from acute respiratory failure. Serum creatinine (SCr) and blood urea nitrogen (BUN) levels declined obviously after CRRT and peritoneal dialysis (P<0.05), and all the patients were shown to have stable hemodynamics in the course of treatment, and no hemorrhage or embolism occurred. Conclusions　ARF after cardiac surgery should be detected early and treated in time. CRRT and peritoneal dialysis are safe, convenient and effective procedures, and may decrease the mortality rate in patients with ARF after cardiac surgery. DOI: 10.11855/j.issn.0557-7402.2015.04.13