title: Renal outcomes analysis after endovascular and open aortic aneurysm repair.
abstract: OBJECTIVE
  The purpose of this study was to compare renal outcomes (glomerular filtration rate [GFR] and renal volume) after endovascular aneurysm repair (EVAR) and open repair (OR) of abdominal aortic aneurysm (AAA).
  
  
  METHODS
  All AAA repairs performed between November 2009 and July 2011 were included in this retrospective study. Patients requiring suprarenal clamping and renal bypass or reimplantation and patients requiring fenestrated endografting were excluded from the OR and EVAR groups, respectively. All EVARs were performed with transrenal proximal fixation. Renal volume (calculated with a three-dimensional workstation) and GFR (estimated with the Modification of Diet in Renal Disease formula) were evaluated before the procedure, at 12 months after the procedure, and yearly thereafter.
  
  
  RESULTS
  The study included 90 patients (41 ORs and 49 EVARs). Both groups were comparable except for age at intervention, body mass index, smoking, peripheral arterial disease, arrhythmia, and vitamin K antagonist treatment. Median follow-up was 2.8 years for OR (2.5-2.9 years) and 3.2 years for EVAR (3.0-3.4 years). In both groups, we found a significant decrease when comparing postoperative estimated GFR with 1-year (14.4% decrease [3.8%-23.8%]; P = .002) and 3-year (12.8% decrease [3.8%-20.9%]; P = .0007) levels. In both groups, total renal volumes significantly diminished. Median preoperative total renal volume (372 cm(3) [311-349]) significantly decreased (6.7% [2.8%-10.5%]; P = .008) between 1 year and 2 years of follow-up.
  
  
  CONCLUSIONS
  Renal function impairment is similar after open and endovascular AAA repair. It is associated with a decrease in total renal volume, which seems to be an early and constant marker of postoperative renal impairment.
authors.affiliation: Department of Vascular Surgery, Aortic Centre, CHRU Lille, Lille, France.
authors.forename: Teresa
authors.initials: T
authors.lastname: Martin-Gonzalez
authors.affiliation: Department of Vascular Surgery, Aortic Centre, CHRU Lille, Lille, France.
authors.forename: Claire
authors.initials: C
authors.lastname: Pinçon
authors.affiliation: Department of Vascular Surgery, Aortic Centre, CHRU Lille, Lille, France.
authors.forename: Adrien
authors.initials: A
authors.lastname: Hertault
authors.affiliation: Department of Vascular Surgery, Aortic Centre, CHRU Lille, Lille, France.
authors.forename: Blandine
authors.initials: B
authors.lastname: Maurel
authors.affiliation: Department of Vascular Surgery, Aortic Centre, CHRU Lille, Lille, France.
authors.forename: Damien
authors.initials: D
authors.lastname: Labbé
authors.affiliation: Department of Vascular Surgery, Aortic Centre, CHRU Lille, Lille, France.
authors.forename: Rafaëlle
authors.initials: R
authors.lastname: Spear
authors.affiliation: Department of Vascular Surgery, Aortic Centre, CHRU Lille, Lille, France.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Sobocinski
authors.affiliation: Department of Vascular Surgery, Aortic Centre, CHRU Lille, Lille, France. Electronic address: stephan.haulon@chru-lille.fr.
authors.forename: Stéphan
authors.initials: S
authors.lastname: Haulon
mesh_terms: D000368:Aged; D017544:Aortic Aneurysm, Abdominal / Q000175:diagnosis / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects*; D057510:Endovascular Procedures / Q000009:adverse effects*; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007668:Kidney / Q000000981:diagnostic imaging / Q000503:physiopathology; D007674:Kidney Diseases / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome