{"title":"Renal complications following endovascular repair of abdominal aortic aneurysms.","authors":"S R Walker, S W Yusuf, P W Wenham, B R Hopkinson","doi":"10.1583/1074-6218(1998)005<0318:RCFERO>2.0.CO;2","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the renal complications associated with endovascular repair of abdominal aortic aneurysms (AAAs).</p><p><strong>Methods: </strong>Data were prospectively collected on 164 AAA patients (154 males; median age 72 years; interquartile range 51 to 88) undergoing endovascular grafting. Any history of renal failure and diabetes mellitus was recorded. Serum urea and creatinine levels were measured preoperatively and at regular intervals postoperatively. Renal impairment was defined as serum creatinine > 130 micromol/L.</p><p><strong>Results: </strong>There were no significant differences in pre- and 1-day postoperative serum urea and creatinine levels. Among 15 (9.1%) patients with preoperative renal failure, 7 (47%) died, 4 (27%) in the perioperative period. Of the 149 patients with normal renal function preoperatively, 4 (2.7%) developed renal failure as part of multisystem organ failure. Another 9 (6.2%) developed significant postoperative elevations (> 20%) in their creatinine levels compared to baseline; 4 of these patients died, 2 in the perioperative period. There was no significant difference in the median dose of intravascular contrast used for those patients that did and did not have a deterioration in their renal function (250 mL versus 300 mL).</p><p><strong>Conclusions: </strong>In this study, approximately 6% of patients with normal preoperative renal function who undergo endovascular AAA repair develop renal dysfunction. For patients with preoperative renal impairment, the perioperative mortality rate is high, 27%, following endovascular aortic aneurysm repair.</p>","PeriodicalId":79443,"journal":{"name":"Journal of endovascular surgery : the official journal of the International Society for Endovascular Surgery","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"1998-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"30","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of endovascular surgery : the official journal of the International Society for Endovascular Surgery","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1583/1074-6218(1998)005<0318:RCFERO>2.0.CO;2","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 30
Abstract
Purpose: To investigate the renal complications associated with endovascular repair of abdominal aortic aneurysms (AAAs).
Methods: Data were prospectively collected on 164 AAA patients (154 males; median age 72 years; interquartile range 51 to 88) undergoing endovascular grafting. Any history of renal failure and diabetes mellitus was recorded. Serum urea and creatinine levels were measured preoperatively and at regular intervals postoperatively. Renal impairment was defined as serum creatinine > 130 micromol/L.
Results: There were no significant differences in pre- and 1-day postoperative serum urea and creatinine levels. Among 15 (9.1%) patients with preoperative renal failure, 7 (47%) died, 4 (27%) in the perioperative period. Of the 149 patients with normal renal function preoperatively, 4 (2.7%) developed renal failure as part of multisystem organ failure. Another 9 (6.2%) developed significant postoperative elevations (> 20%) in their creatinine levels compared to baseline; 4 of these patients died, 2 in the perioperative period. There was no significant difference in the median dose of intravascular contrast used for those patients that did and did not have a deterioration in their renal function (250 mL versus 300 mL).
Conclusions: In this study, approximately 6% of patients with normal preoperative renal function who undergo endovascular AAA repair develop renal dysfunction. For patients with preoperative renal impairment, the perioperative mortality rate is high, 27%, following endovascular aortic aneurysm repair.
目的:探讨腹主动脉瘤血管内修复术中的肾脏并发症。方法:前瞻性收集164例AAA患者的资料(男性154例;中位年龄72岁;四分位数范围为51 ~ 88)。有无肾功能衰竭和糖尿病史。术前和术后定期测定血清尿素和肌酐水平。血清肌酐> 130微mol/L为肾功能损害。结果:两组患者术后1天血清尿素和肌酐水平无显著差异。术前肾功能衰竭15例(9.1%),死亡7例(47%),围手术期死亡4例(27%)。149例术前肾功能正常的患者中,4例(2.7%)出现肾功能衰竭,为多系统器官功能衰竭的一部分。另外9例(6.2%)患者术后肌酐水平显著升高(> 20%);4例死亡,2例围手术期死亡。在有肾功能恶化和没有肾功能恶化的患者中,血管内造影剂的中位剂量没有显著差异(250 mL vs 300 mL)。结论:在这项研究中,约6%术前肾功能正常的患者在接受血管内AAA修复后出现肾功能障碍。对于术前肾损害的患者,血管内动脉瘤修复后围手术期死亡率高达27%。