+ Resolve Article
+ Follow Us
Follow on FacebookFollow on Facebook
Follow on TwitterFollow on Twitter

+ Translate
+ Subscribe to Site Feed
GeoScience Most Shared ContentMost Shared Content

The impact of aortic endografts on renal function

, : The impact of aortic endografts on renal function. Journal of Vascular Surgery 41(6): 926-930

Objective: To determine the impact on late postoperative renal function of supra-renal and infrarenal fixation of endografts used to treat infrarenal abdominal aortic-aneurysm (AAA). Methods: Retrospective analysis of 277 patients treated from 2000 to 2003 with three different endografts at two clinical centers. Five patients on dialysis for preoperative chronic renal failure were excluded. Group IF of 135 patients treated with an infraternal device (Medtronic AneuRx) was compared with group SF of 137 patients treated with a suprarenal device (106 Cook Zenith and 31 Medtronic Talent). Renal function was evaluated by calculating preoperative and latest postoperative creatinine clearance (CrCl) using the Cockcroft formula. Patients who developed a >20% decrease in CrCl were considered to have significantly impaired renal function.Results. There were no significant differences in patient age, sex, aneurysm size, preoperative risk factors, dose of intra-and postoperative contrast, or baseline CrCl (IF: 69.3 mL/min, SF: 71.7 mL/min, P =.4). Follow-up time of 12.2months was the same in both groups. CrCl decreased significantly during the follow-up period-in both groups (IF: 69.3 mL/min to 61.7 mL/min, P <.01; SF: 71.7 mL/min to 64.9 mL/min, P <.03). Postoperative CrCl (IF: 61.7 mL/min, SF: 64.9 mL/min, P =.3), and the rate of CrCl decrease during the follow-up period (IF: - 10.9%) SF: - 9.5%, P =.2) was not different between the two groups. The number of patients with a >20% decrease in CrCl was not different between the two groups (IF: n = 35 [25.9%], SF: n = 41 [29.9%], P =.46). However, the magnitude of decrease in CrCl in patients with renal impairment was greater in patients treated with suprarenal fixation endografts (SF: -39%) compared with those treated with infrarenal endografts (IF: - 31%, P =.005). This greater degree of renal impairment was not due to identifiable differences in preoperative risk factors, age, or baseline CrCl. No patients in these series required dialysis.Conclusions. Regardless the type of endograft used, there is a 10% decrease inCrCl in the first year after endovascular aneurysm repair. Suprarenal fixation does not seem to increase the likelihood of postoperative renal impairment. Decline in renal function over time after endovascular aortic repair is probably due to multiple factors, and measures known to be effective in protecting kidneys should be considered for these patients. Long-term follow-up with measurement of CrCl, along with renal imaging and regular blood pressure measurements, should be performed to detect-possible late renal dysfunction. Prospectivestudies comparing suprarenal versus infrarenal fixation are needed to confirmthose results.


PMID: 15944586

DOI: 10.1016/j.jvs.2005.02.024

Other references

Vasojevic, S.; Suvakovic, V.; Ciric, D.; Groza, A., 1961: Infectious hepatitis and hepatic coma (report of 3 cases). Medicinski Glasnik 15: 330-334

Filosa, J.A.; Blanco, Víctor.M., 2007: Neurovascular coupling in the mammalian brain. Normal brain function requires proper supply of oxygen and glucose in a timely and local manner. This is achieved through an orchestrated intercellular communication between neurones, astrocytes and microvessels that results in a rapid and restric...

Matsagas, M.I.; Geroulakos, G.; Mikhailidis, D.P., 2002: The role of platelets in peripheral arterial disease: therapeutic implications. Peripheral arterial disease (PAD) is associated with platelet hyperaggregability as well as an increase in morbidity and mortality from myocardial infarction and stroke. Enhanced platelet activation in PAD may substantially contribute to these adv...

Spiller, H.A.; Morse, S.; Muir, C., 1990: Fluoxetine ingestion: a one year retrospective study. Fluoxetine (PROZAC) is a recently marketed straight chain antidepressant unrelated to the cyclic anti-depressants. There is only limited information on fluoxetine and a single case report on overdose (benign outcome) in the literature. In response...

Ambrus, B., 1971: Beitrage zur Kenntnis der heimischen Gallenfauna,9. Aus den Gallen der Arboreta in Tiszakurt and Tiszaigar. Folia ent: 403-426.

Mencucci, R.; Favuzza, E.; Tartaro, R.; Busin, M.; Virgili, G., 2016: Descemet stripping automated endothelial keratoplasty in Fuchs' corneal endothelial dystrophy: anterior segment optical coherence tomography and in vivo confocal microscopy analysis. To evaluate the in vivo corneal changes using in vivo confocal microscopy (IVCM) and anterior segment optical coherence tomography (AS-OCT) in patients with Fuchs' dystrophy who underwent Descemet stripping automated endothelial keratoplasty...

Liu, Y.; Karkamkar, A.; Pinnavaia, T.J., 2002: Redirect the assembly of hexagonal MCM-41 into cubic MCM-48 from sodium silicate without the use of an organic structure modifier. In contrast to earlier methods requiring the presence of organic modifiers for the preparation of cubic MCM-48 mesostructures from low cost sodium silicate, we show that this three dimensional framework structure can be readily assembled in the ab...

Iancu T.C.; Neustein H.B.; Landing B.H., 1977: Ferritin segregation within human liver cell lysosomes during iron overload. Israel Journal of Medical Sciences 13(3): 341

Moyer, M.M.; Gadoury, D.M.; Cadle-Davidson, L.; Dry, I.B.; Magarey, P.A.; Wilcox, W.F.; Seem, R.C., 2010: Effects of acute low-temperature events on development of Erysiphe necator and susceptibility of Vitis vinifera. Growth and development of Erysiphe necator (syn. Uncinula necator) has been extensively studied under controlled conditions, primarily with a focus on development of grapevine powdery mildew within the optimal temperature range and the lethal effe...

Wilms, G.; Marchal, G.; Demaerel, P.H.; Van Hecke, P.; Baert, A.L., 1991: Gadolinium-enhanced MRI of intracranial lesions. A review of indications and results. Clinical Imaging 15(3): 153-165