• European radiology · Jun 2016

    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, and Geert Willem H Schurink.
    • Department of Radiology, Maastricht University Medical Centre, Maastricht, The Netherlands. karmanna@stanford.edu.
    • Eur Radiol. 2016 Jun 1; 26 (6): 1613-9.

    ObjectivesTo analyse predictors for short- and long-term renal function changes after fenestrated and branched endovascular aortic repair (EVAR).MethodsA 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.ResultsForty-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.ConclusionDevelopment of post-EVAR AKI is an independent risk factor for long-term renal function decrease.Key Points• Longer procedure time is associated with an increased risk for AKI. • Renal perfusion defects on angiography are associated with increased risk for AKI. • Post-EVAR AKI is associated with higher probability for long-term eGFR decrease. • Iodinated contrast volume is not an independent risk factor for AKI. • Iodinated contrast volume is not an independent risk factor for long-term eGFR decrease.

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