Comparative analysis of renal function after treatment of infrarenal abdominal aortic aneurysms with a suprarenal fixation device as opposed to open surgery.

摘要

We analyzed the repercussions on renal function between suprarenal endograft fixation and open surgery in the treatment of infrarenal abdominal aortic aneurysms (IAAAs) and determined the influential factors. Between 1999 and 2005, 59 IAAAs were treated with elective OS and 56 with SEF. The serum creatinine (Cr) level and its clearance were determined before the procedure, in the intensive care unit (ICU), on discharge, and after 1, 6, 12, and 24 months. A deterioration in renal function was considered to be a >30% increase in Cr or a Cr >2 mg/dL. A univariate statistical analysis and a logistical regression analysis were carried out to determine the predictive factors for repercussions on renal function. There were no statistically significant differences in the rate of renal exacerbation between the groups either on discharge (p = 0.52) or after 1 month (p = 0.483), 6 months (p = 0.451), 12 months (p = 0.457), and 24 months (p = 0.682). The only significant difference was that detected in the ICU (p = 0.033). Diabetes mellitus, time spent in the ICU, postoperative intubation time, intraoperative transfusion, and transfusion in the ICU were factors that influenced the deterioration of renal function in the univariate analysis. The only significant factor in the multivariate analysis was the need for transfusion in the ICU. Exacerbation of renal function occurred in both groups independently of treatment type. In the immediate postoperative period, hemodynamic deterioration is more frequent in the open surgery group. Renal exacerbation tended to disappear in both groups during follow-up.