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Outcomes of Endovascular Aortic Aneurysm Repair in Kidney Transplant Recipients: Results From a National Quality Initiative.
Bostock, I C; Zarkowsky, D S; Hicks, C W; Stone, D H; Eslami, M H; Malas, M B; Goodney, P P.
Afiliación
  • Bostock IC; Division of Vascular and Endovascular Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH.
  • Zarkowsky DS; Division of Vascular and Endovascular Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH.
  • Hicks CW; Department of Surgery, The Johns Hopkins Institutes, Baltimore, MD.
  • Stone DH; Division of Vascular and Endovascular Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH.
  • Eslami MH; Division of Vascular and Endovascular Surgery, Boston University School of Medicine, Boston, MA.
  • Malas MB; Department of Surgery, The Johns Hopkins Institutes, Baltimore, MD.
  • Goodney PP; Division of Vascular and Endovascular Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH.
Am J Transplant ; 16(8): 2395-400, 2016 08.
Article en En | MEDLINE | ID: mdl-26813253
Contrast-induced nephropathy after endovascular aortic aneurysm repair (EVAR) in kidney transplant recipients (KTRs) can have devastating consequences. The Vascular Quality Initiative (VQI) database was queried to select all KTRs who underwent EVAR between January 2003 and December 2014. Our primary outcome was renal dysfunction, defined as acute kidney injury (AKI; elevation of serum creatinine >0.5 mg/dL from baseline) or new postoperative hemodialysis requirement. Within the EVAR VQI dataset, 40 patients were KTRs (40 of 17 213, or 0.2%). Renal dysfunction occurred in five of 40 patients in the KTR group in comparison to 779 of 17 173 patients in the nontransplanted group (12.5% versus 4.5%, p < 0.01). Emergent EVAR was required in 2 (5%) patients, one of whom required dialysis after surgery and subsequently died. One-year survival after EVAR was similar in the two groups (92.9% versus 93.1%, p = 0.73). KTRs who developed renal dysfunction had significantly lower preoperative estimated glomerular filtration rates (eGFRs) (29.5 versus 54.7, p = 0.007) and a significantly higher iodine:eGFR ratio (0.78 versus 0.39, p = 0.02) despite receiving a similar volume of contrast (70.0 versus 68.8, p = 0.97). Renal dysfunction is 3 times more frequent in KTRs treated with EVAR, though overall survival did not differ between the groups. Decreased preoperative eGFR and a higher iodine:eGFR ratio are associated with postoperative renal dysfunction.
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Texto completo: 1 Bases de datos: MEDLINE Asunto principal: Trasplante de Riñón / Aneurisma de la Aorta Abdominal / Insuficiencia Renal Crónica / Procedimientos Endovasculares / Fallo Renal Crónico Tipo de estudio: Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Aged / Female / Humans / Male / Middle aged País/Región como asunto: America do norte Idioma: En Revista: Am J Transplant Asunto de la revista: TRANSPLANTE Año: 2016 Tipo del documento: Article

Texto completo: 1 Bases de datos: MEDLINE Asunto principal: Trasplante de Riñón / Aneurisma de la Aorta Abdominal / Insuficiencia Renal Crónica / Procedimientos Endovasculares / Fallo Renal Crónico Tipo de estudio: Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Aged / Female / Humans / Male / Middle aged País/Región como asunto: America do norte Idioma: En Revista: Am J Transplant Asunto de la revista: TRANSPLANTE Año: 2016 Tipo del documento: Article