OBJECTIVES: To assess the outcome of AAA repair in patients with established renal failure (RF), including patients on dialysis. DESIGN: Retrospective case-control study in a teaching hospital. Methods. All patients with established RF undergoing AAA repair were identified during the last eight years. Data was collected from patient notes on operative difficulty, hospital mortality, survival time and future dialysis requirements. For comparison, 28 consecutive patients undergoing AAA repair without RF were studied prospectively. RESULTS: Thirteen RF patients were identified. Three were receiving Continuous Ambulatory Peritoneal Dialysis (CAPD), three were receiving Haemodialysis (HD) and seven had established RF, but were not receiving dialysis. Compared with the control patients, RF patients had a longer total hospital stay (p=0.03, 95% CI for median stay -24.3 to -4.0 days), more postoperative complications (p<0.01, 95% CI 26.4-73.7%) and had an increased in-hospital mortality (p=0.02, 95% CI 4.6-54.3%). Four of the six survivors who were non-dialysis-dependent required long-term dialysis postoperatively. CONCLUSIONS: AAA repair in RF patients is associated with increased postoperative morbidity and mortality. Previously non-dialysis-dependent patients have a high risk of subsequent long-term dialysis.
OBJECTIVES: To assess the outcome of AAA repair in patients with established renal failure (RF), including patients on dialysis. DESIGN: Retrospective case-control study in a teaching hospital. Methods. All patients with established RF undergoing AAA repair were identified during the last eight years. Data was collected from patient notes on operative difficulty, hospital mortality, survival time and future dialysis requirements. For comparison, 28 consecutive patients undergoing AAA repair without RF were studied prospectively. RESULTS: Thirteen RFpatients were identified. Three were receiving Continuous Ambulatory Peritoneal Dialysis (CAPD), three were receiving Haemodialysis (HD) and seven had established RF, but were not receiving dialysis. Compared with the control patients, RFpatients had a longer total hospital stay (p=0.03, 95% CI for median stay -24.3 to -4.0 days), more postoperative complications (p<0.01, 95% CI 26.4-73.7%) and had an increased in-hospital mortality (p=0.02, 95% CI 4.6-54.3%). Four of the six survivors who were non-dialysis-dependent required long-term dialysis postoperatively. CONCLUSIONS: AAA repair in RFpatients is associated with increased postoperative morbidity and mortality. Previously non-dialysis-dependent patients have a high risk of subsequent long-term dialysis.
Authors: Virendra I Patel; Robert T Lancaster; Emel Ergul; Mark F Conrad; Daniel Bertges; Marc Schermerhorn; Philip Goodney; Richard P Cambria Journal: J Vasc Surg Date: 2015-12 Impact factor: 4.268