High incidence of renal failure in patients with aortic aneurysms.
BACKGROUND
Renal failure (RF) is a well-recognized complication of aortic aneurysms (AA) although its incidence has been poorly documented previously. The purpose of this study is to examine the incidence of RF in patients with AA and prognosis of AA patients with RF.


METHODS
Renal function, complications and prognosis of AA patients with RF were retrospectively reviewed in 350 AA patients (median age 69.8+/-10.7 years) in the International Medical Center of Japan from 1989 to 1999.


RESULTS
Among 350 patients with AA, 90 patients (25.7%) had chronic renal failure (CRF) at the initiation of follow-up. The number of CRF patients increased to 117 (33.4%) at 30 months of follow-up. Forty-four out of 160 patients (27.5%) who had aortic surgery developed postoperative acute renal failure (ARF). Stepwise logistic regression analysis revealed that age (>or=65 years), hypertension and multiple aneurysms were independent risk factors for CRF, whereas dissecting aneurysms, preoperative serum creatinine (sCr) levels and duration of surgery were independent risk factors for postoperative ARF in AA patients. In the 5-year follow-up of AA patients with CRF, the mean slopes of 1/serum-creatinine did not significantly differ between conservative treatment and surgical treatment. The survival rates were 49.5% in the conservative treatment group and 67.3% in the surgical treatment group.


CONCLUSIONS
Our data suggest that the management of renal function including blood pressure from an early stage in AA patients is important since CRF is highly prevalent in AA patients and affects their prognosis and mortality.
Hagiwara
Shinji
S
Department of Nephrology, International Medical Center of Japan, 2-1-1 Hongo, Bunkyo-ku, 113-8421, Tokyo, Japan.
Saima
Shigeki
S
Negishi
Kousuke
K
Takeda
Ryo
R
Miyauchi
Naoko
N
Akiyama
Yurika
Y
Horikoshi
Satoshi
S
Tomino
Yasuhiko
Y
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001014:Aortic Aneurysm / Q000150:complications* / Q000401:mortality / Q000473:pathology / Q000601:surgery; D050197:Atherosclerosis / Q000150:complications; D003324:Coronary Artery Disease / Q000150:complications; D003404:Creatinine / Q000097:blood; D018450:Disease Progression; D005260:Female; D006801:Humans; D015994:Incidence; D007676:Kidney Failure, Chronic / Q000209:etiology* / Q000401:mortality; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate
D003404:Creatinine