Impact of Chronic Renal Failure on Surgical Outcomes in Patients with Infective Endocarditis

Abstract Background Patients with chronic renal failure (CRF) on hemodialysis are at increased risk for developing infective endocarditis (IE). However, outcomes of surgical treatment for IE in these patients have not been well studied. Methods Between 1997 to 2017, 539 patients underwent surgery for IE. Of these patients, 125 were on hemodialysis for end-stage renal disease (ESRD) and 414 had no history of CRF. Primary endpoints compared in this study were short- and long-term survival. Results Preoperatively, dialysis patients had higher incidences of diabetes (43% vs. 18%), hypertension (79% vs. 49%), congestive heart failure (63% vs. 48%), cardiogenic shock (13% vs. 5.3), and sepsis (29% vs. 18%), all p Conclusions In ESRD patients with IE, poor postoperative outcomes emphasized the importance of prevention and raised the question of whether indications for surgery in the general population are appropriate for patients who are dialysis-dependent. Additionally, low rates of reoperation supported the use of bioprosthetic valves in these patients.