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Cirugía y cirujanos
On-line version ISSN 2444-054XPrint version ISSN 0009-7411
Abstract
HINOJOSA, Carlos A. et al. Factors that impact kidney function during open and endovascular reconstruction of aortic aneurysms. Cir. cir. [online]. 2019, vol.87, n.2, pp.170-175. Epub Nov 29, 2021. ISSN 2444-054X. https://doi.org/10.24875/ciru.18000448.
Background:
To analyze the factors that influence the deterioration of postoperative renal function in patients undergoing open or endovascular aortic reconstruction, and the impact on survival.
Method:
Retrospective review of patients who underwent invasive treatment was conducted. Demographics, laboratory data, clinical, intraoperative and postoperative variables were recorded; renal function was determined, Fisher's exact test was used to find associations and Kaplan Meier analysis to estimate survival.
Results:
From 2007 to 2017, 80 patients (mean age: 70 years) were studied. Fifty-eight (73%) were male, none of these patients had known diagnosis of chronic kidney insufficiency. Twelve (15%) patients had elevated creatinine in the postoperative period; variables such as intraoperative bleeding greater than 1500 ml were associated with acute renal failure (p = 0.005). During the follow-up period of 60 months, 8 (10%) patients progressed to chronic renal failure, 2 (2.5%) requiring hemodialysis, 18 (22%). Age, gender, comorbidities and anatomic characteristics of the aneurysm, type of intervention or level of aortic cross-clamping did not impact the postoperative renal function.
Conclusions:
The repair of complex aortic aneurysms continues to be a challenge. Intraoperative bleeding greater than 1500 ml and the need of blood transfusion was associated with deterioration of postoperative renal function, affecting the 5-year survival of patients.
Keywords : Aortic aneurysms; Aortic reconstruction; Kidney function.