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Abstract: PO0879

Outcomes of ESKD Patients on Hemodialysis vs. Peritoneal Dialysis Post Open Heart Surgery

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Bassil, Elias, Cleveland Clinic, Cleveland, Ohio, United States
  • Matta, Milad, Cleveland Clinic, Cleveland, Ohio, United States
  • Liaqat, Aimen, Cleveland Clinic Glickman Urological and Kidney Institute, Cleveland, Ohio, United States
  • Fawaz, Adam, Cleveland Clinic, Cleveland, Ohio, United States
  • Mehdi, Ali, Cleveland Clinic Glickman Urological and Kidney Institute, Cleveland, Ohio, United States
  • Calle, Juan C., Cleveland Clinic Glickman Urological and Kidney Institute, Cleveland, Ohio, United States
  • Taliercio, Jonathan J., Cleveland Clinic Glickman Urological and Kidney Institute, Cleveland, Ohio, United States
  • Elgharably, Haytham, Cleveland Clinic, Cleveland, Ohio, United States
  • Harb, Serge C., Cleveland Clinic, Cleveland, Ohio, United States
  • Daou, Remy, Universite Saint-Joseph, Beirut, Lebanon
  • Arrigain, Susana, Cleveland Clinic, Cleveland, Ohio, United States
  • Schold, Jesse D., Cleveland Clinic, Cleveland, Ohio, United States
  • Nakhoul, Georges, Cleveland Clinic Glickman Urological and Kidney Institute, Cleveland, Ohio, United States
Background

ESKD patients on dialysis suffer from poor outcomes following cardiac surgery compared to the non-dialysis populations. However, the impact of the dialysis modality and the type of cardiac surgery are not well studied.

Methods

We identified 590 patients with ESKD on HD or PD who underwent Coronary Artery Bypass Graft (CABG) and/or valvular cardiac surgery using our Electronic Health Records-based Cardio-Thoracic Surgery (CTS) registry from 2009-2019. Baseline demographics and comorbidities of PD and HD were compared using Chi-square, and t-tests for categorical and continuous variables, respectively. In hospital death, hospital length of stay (LOS), intensive care unit LOS, red blood cell transfusions required, and the incidence of post-operative complications including (pericardial effusions requiring intervention, gastro-intestinal bleed (GIB), and sternal wound infections) were compared using Kruskal-Wallis test, Chi-square and Fisher’s exact tests.

Results

Out of 590 patients, 62 (11%) were on PD, and 528 (89%) were on IHD. 277 (47%) underwent Valvular Surgery (VS) only, 158 (26.7%) CABG only, and 155 (26.3%) had combined CABG and VS. Baseline characteristics and comorbidities were similar between the PD and HD groups. In patients undergoing CABG only, PD patients had more pericardial effusions (12.5% vs 2.3% p = 0.048) and more GIB (12.5% vs 2.2% p = 0.046) (Table 1). There were no differences in in-hospital mortality, hospital length of stay (LOS), ICU LOS, and sternal wound infections between groups across the different surgeries. 16 PD patients were converted to HD post-surgery, intent to treat analysis was applied for these patients.

Conclusion

In patients on maintenance dialysis, patients who underwent CABG, VS, and combined surgery had similar outcomes. PD patients appeared to experience more GIB and pericardial effusions requiring intervention in the CABG group.

Table 1