Lee Jeahong, Park Keun-Myoung, Jung Sungteak, Cho Wonpyo, Hong Kee Chun, Jeon Yong Sun, Cho Soon Gu, Lee Jung Bum
Department of Surgery, Inha University College of Medicine, Incheon, Korea.
Department of Radiology, Inha University College of Medicine, Incheon, Korea.
Vasc Specialist Int. 2017 Dec;33(4):135-139. doi: 10.5758/vsi.2017.33.4.135. Epub 2017 Dec 31.
Acute kidney injury (AKI) is an important postoperative complication that may impact mortality and morbidity. The incidence of AKI after elective endovascular aneurysm repair (EVAR) is not known well. The aim of this study is to assess the incidence of AKI after elective EVAR and examine the impact of AKI.
Data were collected and analyzed retrospectively from 78 elective EVARs for abdominal aortic aneurysm (AAA) among 102 total cases of conventional EVAR performed in Inha University Hospital from 2009 to 2015. The primary endpoint was incidence and risk factors of AKI. Secondary endpoints included drop in estimated glomerular filtration rate (eGFR) and the mortality of AKI.
We included 78 patients (17 females, 21%; mean age, 73.9±12.5 years; mean AAA diameter, 59.3±8.9 cm), 11 (14.1%) of whom developed AKI. Within 48 hours, those with AKI experienced a decrease in eGFR from 65.5±21.2 to 51.2±19.6 mL/kg/1.73 m, and those without AKI showed a change from 73.1±9.2 to 74.2±10.7 mL/kg/1.73 m. There were no patients who required dialysis during follow-up (mean, 24.2±18.0 months). Development of AKI was related to operation time (odds ratio [OR], 2.024; 95% confidence interval [CI], 1.732-4.723; P<0.010) and contrast dose (OR, 3.192; 95% CI, 2.182-4.329; P<0.010). There were no differences in mortality between the 2 groups (P=0.784).
The incidence of AKI after EVAR was related to operation time and contrast dose, but was not associated with medium-term mortality.
急性肾损伤（AKI）是一种重要的术后并发症，可能影响死亡率和发病率。择期血管内动脉瘤修复术（EVAR）后AKI的发病率尚不清楚。本研究的目的是评估择期EVAR术后AKI的发病率，并探讨AKI的影响。
回顾性收集并分析2009年至2015年在仁荷大学医院进行的102例传统EVAR手术中78例腹主动脉瘤（AAA）择期EVAR的数据。主要终点是AKI的发病率和危险因素。次要终点包括估计肾小球滤过率（eGFR）下降和AKI的死亡率。
我们纳入了78例患者（17例女性，占21%；平均年龄73.9±12.5岁；平均AAA直径59.3±8.9 cm），其中11例（14.1%）发生了AKI。在48小时内，发生AKI的患者eGFR从65.5±21.2降至51.2±19.6 mL/kg/1.73 m²，未发生AKI的患者从73.1±9.2变为74.2±10.7 mL/kg/1.73 m²。随访期间（平均24.2±18.0个月）没有患者需要透析。AKI的发生与手术时间（比值比[OR]，2.024；95%置信区间[CI]，1.732 - 4.723；P<0.010）和造影剂剂量（OR，3.192；95%CI，2.182 - 4.329；P<0.010）有关。两组之间的死亡率没有差异（P = 0.784）。
EVAR术后AKI的发病率与手术时间和造影剂剂量有关，但与中期死亡率无关。
