Incidence and Independent Risk Factors of Acute Kidney Injury after Thoracic Endovascular Aortic Repair (TEVAR)

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Sarinya Chanthawong

Abstract

Introduction: Acute kidney injury (AKI) significantly increases morbidities and mortality rate and associate with poor outcome after endovascular procedures. Recognition of the incidence and risk factors of AKI is important. This study investigates the incidence, independent risk factors of AKI after thoracic endovascular aortic repair (TEVAR). Methods: We retrospectively reviewed patients who underwent TEVAR diagnosed AKI by RIFLE criteria in Khon Kaen University. The incidence of AKI and outcomes were collected. The risk factors of AKI were identified and analyzed. Results: The total 94 patients, 8 (8.5%) developed AKI after TEVAR. The patient with AKI had higher percentage of preexisting renal failure, blood loss, and packed red cell use [(62.50% vs. 19.77%, p = 0.016), (1508.75±1928.33 vs. 389.16±505.64 mL, p < 0.001), (5.0±3.35 vs. 2.64±1.6 unit, p =0.011), respectively]. Postoperative serum creatinine in patients with AKI was significantly higher (3.14±2.04 vs. 1.17±0.66 mg/dL, p <0.001). Intensive care unit (ICU) and hospital length of stay were increasing in patients with AKI (6.97±7.58 vs. 3.13±2.28 day, p = 0.001 and 27.38±27.30 vs. 14.20±10.90 day, p = 0.007, respectively). Logistic regression analysis, history of preexisting renal failure was independent risk factors for AKI after TEVAR [Adjusted Odds ratio (95% CI) 5.68 (1.01-32.18), p = 0.046]. Conclusions: Acute kidney injury after thoracic endovascular aortic repair is uncommon. Preoperative preexisting renal failure was identified as an independent risk factor of acute kidney injury.

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