CARDIOVASCULAR RADIOLOGY / ORIGINAL PAPER
The risk of renal function deterioration in abdominal aortic stent graft patients with and without previous kidney function failure – an analysis of risk factors
1
Department of General Surgery, Vascular Surgery, Angiology and Phlebology, Medical University of Silesia, Katowice
2
1st Department of Cardiology, Medical University of Silesia, Katowice
Submission date: 2020-04-30
Final revision date: 2020-06-11
Acceptance date: 2020-06-16
Publication date: 2020-12-15
Pol J Radiol, 2020; 85: 643-649
KEYWORDS
renal failureAbdominal aortic aneurysmcontrast induced nephropathyaortic stent-graftabdominal aortic aneurysm
TOPICS
ABSTRACT
Introduction:
Kidney failure influences the treatment outcomes of abdominal aortic aneurysm (AAA). A prospective study of renal function before and after aortic stent-graft treatment was performed. Special attention was paid to the influence of preoperative kidney function as well as the impact of the radiological follow-up.
Material and methods:
A total of 214 endovascularly treated AAA patients were included. In all cases, pre- and postoperative estimated glomerular filtration rate (eGFR) and serum creatinine were noted. Patients were prospectively followed up for a minimum of two years.
Results:
The baseline eGFR was 69.38 ± 16.29 ml/min/1.73 m2. Chronic kidney disease at baseline was noted in 29% of patients. In the direct postoperative period, acute kidney injury was identified in 8.4% of cases. Additional endovascular procedures within two years of observation were performed in 5.6% of cases, and over the two years of follow-up, in the study group from one to six angio-computed tomographic scans (angio-CT) per patient were performed. The mean eGFR value after the 24-month follow-up was significantly lower than the preoperative value. Among the factors influencing kidney function, an angio-CT during the same hospital stay of the primary stent-graft procedures was identified. The type of stent-graft, contrast volume during the primary procedure, need for reintervention, concomitant disease presence, and statin use did not show statistical significance.
Conclusions:
Angio-CT followed by stent-graft implantation over a short time interval (within the same hospitalisation) significantly worsened renal function in the late follow-up and should be avoided in elective AAA cases.
Kidney failure influences the treatment outcomes of abdominal aortic aneurysm (AAA). A prospective study of renal function before and after aortic stent-graft treatment was performed. Special attention was paid to the influence of preoperative kidney function as well as the impact of the radiological follow-up.
Material and methods:
A total of 214 endovascularly treated AAA patients were included. In all cases, pre- and postoperative estimated glomerular filtration rate (eGFR) and serum creatinine were noted. Patients were prospectively followed up for a minimum of two years.
Results:
The baseline eGFR was 69.38 ± 16.29 ml/min/1.73 m2. Chronic kidney disease at baseline was noted in 29% of patients. In the direct postoperative period, acute kidney injury was identified in 8.4% of cases. Additional endovascular procedures within two years of observation were performed in 5.6% of cases, and over the two years of follow-up, in the study group from one to six angio-computed tomographic scans (angio-CT) per patient were performed. The mean eGFR value after the 24-month follow-up was significantly lower than the preoperative value. Among the factors influencing kidney function, an angio-CT during the same hospital stay of the primary stent-graft procedures was identified. The type of stent-graft, contrast volume during the primary procedure, need for reintervention, concomitant disease presence, and statin use did not show statistical significance.
Conclusions:
Angio-CT followed by stent-graft implantation over a short time interval (within the same hospitalisation) significantly worsened renal function in the late follow-up and should be avoided in elective AAA cases.
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