INFLUENCE OF RENAL-ARTERY BLOOD-FLOW ON RENAL-FUNCTION DURING AORTIC-SURGERY

Background. This study was undertaken to determine the true incidence of renal impairment after aortic surgery and its association with intr aoperative fluctuations in renal artery blood flow and cardiac output. Methods. Direct measurements of renal artery blood flow were undertak en with electromagnetic flowmetry in 19 patients undergoing elective i nfrarenal aortic surgery. Renal function was assessed before and after operation by measurement of creatinine clearance. Results. Twelve pat ients (63%) had renal impairment as defined by a 40% or greater reduct ion in creatinine clearance after operation. This group of patients ha d significantly lower renal artery blood flow during the period of aor tic cross-clamping than had those who preserved their renal function ( p < 0.001). Conclusions. Renal impairment is common after infrarenal a ortic surgery and may be a result of intraoperative ischemia secondary to reduced renal artery blood flow.