title: What are the risk factors for renal failure following open elective abdominal aortic aneurysm repair?
abstract: OBJECTIVE
  Renal failure following abdominal aortic aneurysm (AAA) repair is a common and significant complication. The objective of this study was to identify risk factors for renal failure following open elective AAA repair.
  
  
  METHODS
  A retrospective analysis of prospectively collected multi-centre data.
  
  
  METHODS
  Consecutive data on patients undergoing open elective AAA repair were collected between January 2000 and December 2010. Patients with pre-operative serum creatinine >200 μmol/L were excluded.
  
  
  METHODS
  Renal failure was reported by clinicians and included all patients requiring post-operative renal-replacement therapy. Univariate and multivariate analyses were used to identify renal failure risk factors. A simplified clinical risk score was developed.
  
  
  RESULTS
  Post-operative renal failure occurred in 140 (6.0%) of 2347 patients and was associated with age >75 (OR = 1.58, 95%CI 1.11-2.26), symptomatic AAA (OR = 1.77, 95%CI 1.24-2.52), supra/juxta renal AAA (OR = 2.17, 95%CI 1.32-3.57) pre-operative serum creatinine >150 (OR = 2.75, 95%CI 1.69-4.50), treated hypertension (OR = 1.87, 95%CI 1.28-2.74), and respiratory disease (OR = 2.08, 95%CI 1.45-2.97). Patients with post-operative renal failure had significantly higher 30-day mortality (35.0% vs. 4.3%, p < 0.001).
  
  
  CONCLUSIONS
  Renal failure following open elective AAA repair was associated with an increased risk of mortality. Risk factors for post-operative renal failure were identified and a simple clinical risk score developed to facilitate focussed care strategies for high-risk patients.
authors.affiliation: The University of Manchester, Manchester Academic Health Science Centre, UHSM, Academic Surgery Unit, Education and Research Centre, Southmoor Road, Manchester M23 9LT, UK.
authors.forename: S W
authors.initials: SW
authors.lastname: Grant
authors.forename: A D
authors.initials: AD
authors.lastname: Grayson
authors.forename: M J
authors.initials: MJ
authors.lastname: Grant
authors.forename: D
authors.initials: D
authors.lastname: Purkayastha
authors.forename: C N
authors.initials: CN
authors.lastname: McCollum
mesh_terms: D000367:Age Factors; D000368:Aged; D017544:Aortic Aneurysm, Abdominal / Q000150:complications / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation; D015331:Cohort Studies; D003404:Creatinine / Q000097:blood; D004739:England / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D011183:Postoperative Complications; D011446:Prospective Studies; D051437:Renal Insufficiency / Q000453:epidemiology*; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D003404:Creatinine