Early Start of Dialysis Therapy is Beneficial for Patients with Acute Renal Failure following Cardiac Surgery

Acute renal failure requiring dialysis therapy after cardiac surgery occurs in 1–5% of patients; however, the optimal timing for the initiation of dialysis therapy still remains undetermined. To assess the validity of early start of dialysis therapy, we studied the comparative survival between 14 patients who started to receive dialysis therapy with the timing of decrease of urine volume less than 30 mL/h and other 14 patients who waited to begin dialysis therapy until the level of urine volume of less than 20 mL/h during 14 days. Overall mortality of those patients was 50%. Twelve of 14 patients who received the early intervention survived. In contrast, only 2 of 14 patients in the other group survived. There was a significant difference of p < 0.01 between the two groups. Between the two groups, there were no significant differences in age, sex ratio, the score of APACHE (Acute Physiologic and Chronic Health Evaluation) II, and the levels of serum creatinine at the start of dialysis therapy (2.9 + 0.2 vs. 3.1 + 0.2 mg/dL) as well as in the levels of serum creatinine at admission. The start timing for the treatment of acute renal failure following cardiac surgery would be determined by the decrease of urine volume but not by the levels of serum creatinine. The early start of dialysis therapy might be preferable for the improvement of survival of the patients suffering from acute renal failure following cardiac surgery.