Endovascular treatment of complex aortic aneurysms: prevalence of acute kidney injury and effect on long-term renal functionReport as inadecuate




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European Radiology

, Volume 26, Issue 6, pp 1613–1619

First Online: 02 October 2015Received: 14 June 2015Revised: 26 August 2015Accepted: 31 August 2015

Abstract

ObjectivesTo analyse predictors for short- and long-term renal function changes after fenestrated and branched endovascular aortic repair EVAR.

MethodsA total of 157 patients underwent fenestrated and branched EVAR. Procedural intra-arterial iodinated contrast volume was documented. Serum creatinine and estimated glomerular filtration rate eGFR at baseline, during 48 h following EVAR, at discharge and latest moment of follow-up were recorded. Development of post-EVAR acute kidney injury AKI; according to AKIN criteria, and potential risk factors for renal failure were recorded. Multivariate regression analyses were used to identify independent risk factors for AKI and eGFR decrease during follow-up.

ResultsForty-three patients 28 % developed post-EVAR AKI. Long procedure time and occlusion of accessory renal arteries were independent risk factors for development of AKI. odds ratio OR 1.005 per minute, 95 % CI 1.001–1.01; p = 0.025 and OR 3.02, 95 % CI 1.19–8.16; p = 0.029. Post-EVAR AKI was associated with a significantly increased risk for eGFR decrease at discharge and latest follow-up hazard ratio HR 3.47, 95 % CI 1.63–7.36, p = 0.001 and HR 3.01, 95 % CI 1.56–5.80; p = 0.001. Iodinated contrast volume was not an independent risk factor for AKI or eGFR decrease during follow-up.

ConclusionDevelopment of post-EVAR AKI is an independent risk factor for long-term renal function decrease.

Key Points• Longer procedure time is associated with an increased risk for AKI.

• Renal perfusion defects on angiography are associated with increased risk for AKI.

• Post-EVAR AKI is associated with higher probability for long-term eGFR decrease.

• Iodinated contrast volume is not an independent risk factor for AKI.

• Iodinated contrast volume is not an independent risk factor for long-term eGFR decrease.

KeywordsAcute kidney injury Endovascular procedures Contrast media Glomerular filtration rate Aortic aneurysm  Download fulltext PDF



Author: Anna M. Sailer - Patricia J. Nelemans - Camille van Berlo - Ozan Yazar - Michiel W. de Haan - Dominik Fleischmann - Gee

Source: https://link.springer.com/







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