Renal complications following endovascular repair of abdominal aortic aneurysms

Purpose: To investigate the renal complications associated with endovascula r 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 regula r intervals postoperatively. Renal impairment was defined as serum creatini ne > 130 mu mol/L. Results: There were no significant differences in pre- and 1-day postoperat ive serum urea and creatinine levels. Among 15 (9.1%) patients with preoper ative renal failure, 7 (47%) died, 4 (27%) in the perioperative period. Of the 149 patients with normal renal function preoperatively, 4 (2.7%) develo ped renal failure as part of multisystem organ failure. Another 9 (6.2%) de veloped significant postoperative elevations (> 20%) in their creatinine le vels compared to baseline; 4 of these patients died, 2 in the perioperative period. There was no significant difference in the median dose of intravas cular contrast used for those patients that did and did not have a deterior ation in their renal function (250 mt versus 300 mt). Conclusions: In this study, approximately 6% of patients with normal preope rative renal function who undergo endovascular AAA repair develop renal dys function. For patients with preoperative renal impairment, the perioperativ e mortality rate is high, 27%, following endovascular aortic aneurysm repai r.