What are the outcomes of coronary revascularization among patients with kidney disease?
The outcomes of coronary revascularization among patients with kidney disease can vary depending on the type of revascularization used. The CARDia trial found that the one year results of coronary artery revascularization in diabetes were improved with revascularization compared to optimal medical therapy. However, other studies such as the Arterial Revascularization Therapies Study (ARTS) and a study by Bae et al have found that percutaneous coronary intervention (PCI) may not always result in improved survival compared to coronary artery bypass grafting (CABG) in patients with coronary artery disease and diabetic nephropathy. Additionally, a study by Herzog et al found that dialysis patients in the United States have poorer outcomes after coronary angioplasty, coronary artery stenting, and coronary artery bypass surgery, and this risk is further increased in those with diabetes. Overall, there is evidence that coronary revascularization can reduce mortality in some patients with kidney disease, but the type of revascularization used should be considered in order to maximize outcomes.  