Endovascular vs open AAA repair: similar effects on renal proximal tubular function
| Autor: | T. T. Niemi, L. Lindgren, P.-S. Aho, Mauri Lepäntalo |
|---|---|
| Rok vydání: | 2004 |
| Předmět: |
Male
medicine.medical_specialty Urinary system Paired difference test Renal function 030204 cardiovascular system & hematology Kidney Function Tests CARDIOVASCULAR MEASUREMENTS Statistics Nonparametric 030218 nuclear medicine & medical imaging 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Renal tubular dysfunction Blood loss Acetylglucosaminidase Renin medicine Humans General anaesthesia Prospective Studies Cystatin C Aged Creatinine Analysis of Variance Chi-Square Distribution business.industry Cystatins Surgery Treatment Outcome chemistry Female business Vascular Surgical Procedures Aortic Aneurysm Abdominal |
| Zdroj: | Scandinavian journal of surgery : SJS : official organ for the Finnish Surgical Society and the Scandinavian Surgical Society. 93(1) |
| ISSN: | 1457-4969 |
| Popis: | Aim: To compare the effect of open and endovascular repair on renal function. Materials and methods: In a prospective, non-randomized study twenty-four abdominal aortic aneurysms (AAA) treatable with either method were repaired, 15 using endovascular device (ENDO group) and nine with open surgery with infrarenal aortic cross-clamping (OPEN group). All the patients had standardised general anaesthesia, intravascular fluid therapy and monitoring. Renal function tests and cardiovascular measurements were performed at predetermined intervals. Results: N-acetyl-β-D-glucosaminidase indexed to urinary creatinine (U-NAG/crea), sensitive marker of renal proximal tubular damage, increased similarly in both groups at the end of surgery (two-way ANOVA, p < 0.05). No patient developed clinical renal impairment, on the contrary, creatinine clearance was increased, serum cystatin C (a sensitive marker of renal glomerular filtration) and serum creatinine concentration decreased at 24 hours postoperatively (Wilcoxon paired test, p < 0.05). Intraoperative blood loss and the amount of administered crystalloids were higher in the OPEN than in the ENDO group (Mann-Whitney U-test, p < 0.05). The cardiovascular measurements were comparable between the groups. The mean (SD) amount of radio-contrast media given was 3.1 (1.1) ml/kg in the ENDO group. Conclusions: Our results indicate that endovascular AAA repair does not protect renal proximal tubular function. A temporary renal tubular dysfunction was found both in open and in endovascular AAA repair which did not lead to permanent changes in renal function. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|