• Gabriele Piffaretti, Giovanni Mariscalco, Stefano Bonardelli, Antonio Sarcina, Guido Gelpi, Raffaello Bellosta, Maurizio De Lucia, Franco Nodari, Edoardo Cervi, Gianpaolo Carrafiello, Carlo Antona, and Patrizio Castelli.
• Vascular Surgery, Department of Surgery and Morphological Sciences, Circolo University Hospital, University of Insubria School of Medicine, Varese, Italy. gabriele.piffaretti@uninsubria.it
• J. Vasc. Surg. 2012 Dec 1;56(6):1527-34.

BackgroundThis study analyzed the incidence and the predictive factors of postoperative acute kidney injury (AKI) after thoracic endovascular aortic repair (TEVAR) and evaluated the effect of AKI on postoperative survival.MethodsBetween November 2000 and April 2011, all consecutive patients undergoing TEVAR of the descending thoracic or thoracoabdominal aorta were enrolled at four teaching hospitals. Estimated glomerular filtration rate (eGFR) was evaluated during the entire hospitalization. AKI was defined by the RIFLE (Risk, Injury, Failure, Loss of function, End-stage renal disease) consensus criteria.ResultsThe study included 171 patients (80% men) who were a mean age of 69±14 years (range, 18-87 years). AKI occurred in 24 patients (14%). Independent predictors of postoperative AKI were preoperative depressed eGFR, thoracoabdominal extent, and postoperative transfusion. Patients with AKI experienced major postoperative complications (P=.001), longer hospitalization (P=.008), and higher hospital mortality (29% vs 4%; P<.001). Kaplan-Meier analysis showed a survival of 82%, 51%, and 51% at 1, 3, and 5 years for patients who developed AKI, which was significantly worse than the 99%, 89%, and 80% for patients who did not experience AKI (P=.001).ConclusionsPreoperative poor renal function, blood transfusions, and the thoracoabdominal extent of the aortic disease were the most important predictors for AKI.Copyright © 2012 Society for Vascular Surgery. Published by Mosby, Inc. All rights reserved.

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