Clinical Physiology of Circulation

Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, Director of Bakoulev National Medical Research Center for Cardiovascular Surgery

Acute kidney injury after juxtarenal abdominal aortic aneurysm repair

Authors: A.N. Vachev, I.I. Kozin, O.V. Dmitriev, D.A. Chernovalov, D.A. Gryaznova, A.A. Luk'yanov

Company:
Samara State Medical University, Samara, 443099, Russian Federation

E-mail: Сведения доступны для зарегистрированных пользователей.

DOI: https://doi.org/0.24022/1814-6910-2020-17-3-222-231

UDC: 616.3:616.136

Link: Clinical Physiology of Blood Circulaiton. 2020; 17 (3): 222-231

Quote as: Vachev A.N., Kozin I.I., Dmitriev O.V., Chernovalov D.A., Gryaznova D.A., Luk'yanov A.A. Acute kidney injury after juxtarenal abdominal aortic aneurysm repair. Clinical Physiology of Circulation. 2020; 17 (3): 222–31 (in Russ.). DOI: 10.24022/1814-6910-2020-17-3-222-231

Received / Accepted:  14.05.2020/21.05.2020

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Abstract

Objective. To identify the most significant risk factors for the development of acute kidney injury (AKI) after juxtarenal abdominal aortic aneurysm repair.

Material and methods. A single-center study included 50 patients. Inclusion criteria in the main group (n=25) is the following: patients with juxtarenal abdominal aortic aneurysms whose renal arteries were intraoperatively clamped and reconstructed. The control group included 25 patients with aortic aneurysms who did not undergo clamping of the renal arteries. The main group was further divided into two subgroups. Subgroup A (n=9) is represented by patients without signs of renal dysfunction after the surgery, subgroup B (n=16) includes patients diagnosed with acute kidney injury in the postoperative period.

Results. The studied groups were comparable by age, sex, concomitant diseases and initial renal function before the surgery. After the surgery the AKI developed significantly more frequently in the main group compared to the control group (p=0.001). The groups were significantly different in terms of surgery time (p=0.002), time of renal ischemia (p<0.001), blood loss volume (p=0.001), total infusion volume (p=0.012), plasma transfusion volume (p=0.043) and red blood cell suspension transfusions (p=0.004). The body mass index (BMI) was significantly higher in subgroup B compared to subgroup A (p=0.014). The threshold BMI was 24.59 kg/m2. A perioperative decrease of the urine output was revealed in subgroup B in comparison with subgroup A (p=0.057). Complete recovery of renal function was observed in 81.3% (n=13) of patients with AKI by the time of discharge.

Conclusion. An increased body mass index is an important preoperative factor of acute postoperative renal dysfunction development. A perioperative decrease of the urine output is the earliest indicator of acute kidney injury after surgery.

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About Authors

  • Aleksey N. Vachev, Dr. Med. Sc., Professor, Head of Faculty Surgery Chair and Clinic; orcid.org/0000-0002-4925-0129 
  • Igor' I. Kozin, Cardiovascular Surgeon; orcid.org/0000-0001-9583-4013 
  • Oleg V. Dmitriev, Cand. Med. Sc., Head of Department of Vascular Surgery No. 1 of the Faculty Surgery Clinic; orcid.org/0000-0003-2756-7536 
  • Denis A. Chernovalov, Cand. Med. Sc., Cardiovascular Surgeon; orcid.org/0000-0003-3997-3048 
  • Dina A. Gryaznova, Cardiologist; orcid.org/0000-0001-7148-2017 
  • Aleksey A. Luk'yanov, Cardiovascular Surgeon; orcid.org/0000-0002-6732-5665

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