Postoperative renal function after an abdominal aortic aneurysm repair requiring a suprarenal aortic cross-clamp

We describe herein the postoperative renal functions of patients who requir ed a suprarenal aortic cross-clamp during abdominal aortic surgery. Seven p atients required a unilateral suprarenal aortic cross-clamp (group A) and s ix patients required a bilateral suprarenal clamp (group B). Eighty-three p atients who required an infrarenal aortic clamp were assigned to group C. R enal hypothermia with renal perfusion or topical cooling during suprarenal clamp was not performed. No hospital deaths were encountered. In group B, t he postoperative creatinine and blood urea nitrogen (BUN) levels remained s tatistically significantly higher than that of group C until the seventh po stoperative day. The postoperative renal dysfunction (serum creatinine leve l >2.0 mg/dl) was 28.6% in group A and 50% in group B, while it was only 8. 4% in group C, although no patient required either temporary or permanent h emodialysis. The postoperative peak BUN over 30 min suprarenal clamp was si gnificantly higher than that within 30 min. In summary, the postoperative r enal function was impaired after an extended bilateral suprarenal clamp. Th ese findings suggest that if prolonged renal ischemia is thus expected, the n renal preservation should be considered.