Endovascular treatment of complex aortic aneurysms: prevalence of acute kidney injury and effect on long-term renal function

Anna M. Sailer*, Patricia J. Nelemans, Camille van Berlo, Ozan Yazar, Michiel W. de Haan, Dominik Fleischmann, Gerardus Schurink

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

22 Citations (Web of Science)

Abstract

To analyse predictors for short- and long-term renal function changes after fenestrated and branched endovascular aortic repair (EVAR). A total of 157 patients underwent fenestrated and branched EVAR. Procedural intra-arterial iodinated contrast volume was documented. Serum creatinine and estimated glomerular filtration rate (eGFR) at baseline, during 48 h following EVAR, at discharge and latest moment of follow-up were recorded. Development of post-EVAR acute kidney injury (AKI; according to AKIN criteria), and potential risk factors for renal failure were recorded. Multivariate regression analyses were used to identify independent risk factors for AKI and eGFR decrease during follow-up. Forty-three patients (28 %) developed post-EVAR AKI. Long procedure time and occlusion of accessory renal arteries were independent risk factors for development of AKI. (odds ratio (OR) 1.005 per minute, 95 % CI 1.001-1.01; p = 0.025 and OR 3.02, 95 % CI 1.19-8.16; p = 0.029). Post-EVAR AKI was associated with a significantly increased risk for eGFR decrease at discharge and latest follow-up (hazard ratio (HR) 3.47, 95 % CI 1.63-7.36, p = 0.001 and HR 3.01, 95 % CI 1.56-5.80; p = 0.001). Iodinated contrast volume was not an independent risk factor for AKI or eGFR decrease during follow-up. Development of post-EVAR AKI is an independent risk factor for long-term renal function decrease. aEuro cent Longer procedure time is associated with an increased risk for AKI. aEuro cent Renal perfusion defects on angiography are associated with increased risk for AKI. aEuro cent Post-EVAR AKI is associated with higher probability for long-term eGFR decrease. aEuro cent Iodinated contrast volume is not an independent risk factor for AKI. aEuro cent Iodinated contrast volume is not an independent risk factor for long-term eGFR decrease.
Original languageEnglish
Pages (from-to)1613-1619
JournalEuropean Radiology
Volume26
Issue number6
DOIs
Publication statusPublished - Jun 2016

Keywords

  • Acute kidney injury
  • Endovascular procedures
  • Contrast media
  • Glomerular filtration rate
  • Aortic aneurysm

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