ISSN: 1899-0967
Polish Journal of Radiology
Established by prof. Zygmunt Grudziński in 1926 Sun
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1/2020
vol. 85
 
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Cardiovascular radiology
abstract:
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

Tomasz Urbanek
1
,
Grzegorz Biolik
1
,
Wojciech Zelawski
1
,
Beata Hapeta
2
,
Maciej Juśko
1
,
Waclaw Kuczmik
1

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
Pol J Radiol 2020; 85: e643-e649
Online publish date: 2020/12/15
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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.

keywords:

renal failure, abdominal aortic aneurysm, contrast induced nephropathy, aortic stent-graft

 
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