Impact of renal dysfunction on operative mortality following endovascular abdominal aortic aneurysm surgery.

Abstract

Preoperative renal dysfunction is a significant risk factor for death after open abdominal aortic aneurysm repair. The aim of this study was to determine whether renal dysfunction also affected mortality after endovascular aneurysm repair. Patients from the EUROSTAR registry were stratified into two groups: 4198 with normal renal function (creatinine less than 133 micromol/ml) and 969 with renal dysfunction (serum creatinine more than 133 micromol/ml). Patient characteristics and postoperative complications in the two groups were compared and the effect of renal dysfunction on operative mortality was analysed by multivariable regression models. Patients with renal dysfunction had significantly more co-morbidities, including cardiac and pulmonary impairment. Thirty-day mortality was significantly higher in the group with renal dysfunction (6.2 versus 2.0 per cent; P<0.001). A significant increase in mortality (5.5 per cent) was also seen in patients with moderate renal dysfunction (serum creatinine 133-265 micromol/ml). After adjustment for age and other risk factors, renal dysfunction was still an independent risk factor for 30-day mortality (odds ratio 2.3, 95 per cent confidence interval 1.6 to 3.3; P<0.001). Renal dysfunction was a significant and independent risk factor for death after endovascular aneurysm repair.