title: Intraoperative factors affecting renal outcome after open repair of suprarenal aortic aneurysms.
abstract: BACKGROUND
  The open repair of suprarenal aortic aneurysm requires supraceliac aortic cross-clamping and separate renal artery reconstruction. The aim of this study was to determine the intraoperative factors responsible for postoperative renal dysfunction.
  
  
  METHODS
  Between January 1, 2000 and May 31, 2010, 54 suprarenal aortic aneurysms were repaired at our center (mean age of the patients, 66 ± 8 years). All cases were operated through a left retroperitoneal approach without left renal vein division. Acute kidney injury was defined as a 50% increase of serum creatinine level from the preoperative baseline concentration. Perioperative variables were tested to be correlated with renal dysfunction (Spearman rank).
  
  
  RESULTS
  The ischemic time was 28 ± 8 minutes for the mesentery and the right kidney and 63 ± 16 minutes for the left kidney. The total aortic clamping time was 115 ± 27 minutes. The volume of autologous transfusion was 957 ± 479 mL, allogeneic transfusion was 936 ± 473 mL, and colloids and crystalloids was 7,194 ± 2,201 mL. Two patients died. Acute kidney injury occurred in 15 patients, with complete recovery at discharge. The autologous blood transfusion volume (P = 0.009, r = 0.36) and the total aortic clamping time (P = 0.04, r = 0.30) were correlated with renal dysfunction.
  
  
  CONCLUSIONS
  Postoperative renal dysfunction based on the variation in creatinine serum level was transient and requires further investigation using sensitive biomarkers for tubular ischemia.
authors.affiliation: Department of Anesthesiology, Rouen University Hospital, Rouen, France.
authors.forename: Sylvie
authors.initials: S
authors.lastname: Godier
authors.forename: Marie M
authors.initials: MM
authors.lastname: Dusseaux
authors.forename: Nathalie
authors.initials: N
authors.lastname: David
authors.forename: N
authors.initials: N
authors.lastname: Roux
authors.forename: Benoit
authors.initials: B
authors.lastname: Veber
authors.forename: Bertrand
authors.initials: B
authors.lastname: Dureuil
authors.forename: Didier
authors.initials: D
authors.lastname: Plissonnier
mesh_terms: D058186:Acute Kidney Injury / Q000097:blood / Q000209:etiology* / Q000401:mortality / Q000503:physiopathology; D000368:Aged; D000369:Aged, 80 and over; D001014:Aortic Aneurysm / Q000401:mortality / Q000601:surgery*; D015415:Biomarkers / Q000097:blood; D001803:Blood Transfusion; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects* / Q000401:mortality; D003404:Creatinine / Q000097:blood; D005260:Female; D006801:Humans; D007511:Ischemia / Q000097:blood / Q000209:etiology* / Q000401:mortality / Q000503:physiopathology; D007668:Kidney / Q000098:blood supply* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D012077:Renal Artery / Q000503:physiopathology / Q000601:surgery*; D012079:Renal Circulation; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013152:Splanchnic Circulation; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D003404:Creatinine