title: Acute Kidney Injury after Open Repair of Intact Abdominal Aortic Aneurysms.
abstract: BACKGROUND
  These last years, considerable attention has been given to renal issues following endovascular aortic repair but acute kidney injury (AKI) also remains one of the most frequent complications following open repair (OR). Since AKI definition has evolved, our aim was to review the etiology, incidence, classifications, and consequences of AKI after OR for intact abdominal aortic aneurysm (AAA).
  
  
  METHODS
  A review of the English language literature published between 2004 and 2016 was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria. Studies regarding ruptured AAA, combination of emergency and elective repairs without results stratification, and thoracoabdominal aneurysms were excluded, as well as studies not using recent consensual AKI classifications.
  
  
  RESULTS
  In total, 6 studies including 658 patients (394 from prospective studies and 264 from retrospective studies) used recent consensual classifications (risk injury failure loss end-stage renal disease [RIFLE], Acute Kidney Injury Network classification [AKIN], kidney disease-improving global outcomes [KDIGO], and Aneurysm Renal Injury Score [ARISe]) and were considered for analysis. After infrarenal clamping, AKI rates were quite similar between studies, observed in 24% cases when using the RIFLE classification, 20% cases with the AKIN criteria, and 26.3% cases when using the ARISe classification. Pooled rates of renal replacement therapy (RRT) and 30-day mortality were 0.3% and 1.4%, respectively. In the long term, no patient mandated chronic RRT. After suprarenal clamping, 2 retrospective studies used the RIFLE criteria to define the incidence of AKI, and the pooled AKI rate was 36.8%. The AKI rate was 26.5% in smaller retrospective study using the KDIGO criteria. Rates of RRT and 30-day mortality were 3.8% and 2.9%, respectively. In the long term, 1.2-3% of patients mandated chronic RRT.
  
  
  CONCLUSIONS
  AKI is a common but generally transient complication after OR for AAA. Its incidence depends on definitions used, and few studies were found to use recent consensual AKI criteria. In the future, large prospective studies using consensual AKI definitions will facilitate comparison between repair strategies.
authors.affiliation: Department of Vascular Surgery, Ambroise Paré University Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Boulogne-Billancourt, France.
authors.forename: Charles
authors.initials: C
authors.lastname: Dariane
authors.affiliation: Department of Vascular Surgery, Ambroise Paré University Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Boulogne-Billancourt, France; Faculté de Médecine Paris-Ile de France-Ouest, UFR des sciences de la santé Simone Veil, Université Versailles Saint-Quentin en Yvelines, Montigny-le-Bretonneux, France; CESP, INSERM U-1018 Team 5 (EpReC, Renal and Cardiovascular Epidemiology), UVSQ, Université Paris-Saclay, Hôpital Paul Brousse, Villejuif Cedex, France. Electronic address: rcoscas@gmail.com.
authors.forename: Raphaël
authors.initials: R
authors.lastname: Coscas
authors.affiliation: Department of Vascular Surgery, Ambroise Paré University Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Boulogne-Billancourt, France.
authors.forename: Celia
authors.initials: C
authors.lastname: Boulitrop
authors.affiliation: Department of Vascular Surgery, Ambroise Paré University Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Boulogne-Billancourt, France.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Javerliat
authors.affiliation: Faculté de Médecine Paris-Ile de France-Ouest, UFR des sciences de la santé Simone Veil, Université Versailles Saint-Quentin en Yvelines, Montigny-le-Bretonneux, France; CESP, INSERM U-1018 Team 5 (EpReC, Renal and Cardiovascular Epidemiology), UVSQ, Université Paris-Saclay, Hôpital Paul Brousse, Villejuif Cedex, France; Department of Nephrology, Ambroise Paré University Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Boulogne-Billancourt, France.
authors.forename: Eve
authors.initials: E
authors.lastname: Vilaine
authors.affiliation: Department of Vascular Surgery, Ambroise Paré University Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Boulogne-Billancourt, France; Faculté de Médecine Paris-Ile de France-Ouest, UFR des sciences de la santé Simone Veil, Université Versailles Saint-Quentin en Yvelines, Montigny-le-Bretonneux, France; CESP, INSERM U-1018 Team 5 (EpReC, Renal and Cardiovascular Epidemiology), UVSQ, Université Paris-Saclay, Hôpital Paul Brousse, Villejuif Cedex, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Goeau-Brissonniere
authors.affiliation: Department of Vascular Surgery, Ambroise Paré University Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Boulogne-Billancourt, France; Faculté de Médecine Paris-Ile de France-Ouest, UFR des sciences de la santé Simone Veil, Université Versailles Saint-Quentin en Yvelines, Montigny-le-Bretonneux, France.
authors.forename: Marc
authors.initials: M
authors.lastname: Coggia
authors.affiliation: Faculté de Médecine Paris-Ile de France-Ouest, UFR des sciences de la santé Simone Veil, Université Versailles Saint-Quentin en Yvelines, Montigny-le-Bretonneux, France; CESP, INSERM U-1018 Team 5 (EpReC, Renal and Cardiovascular Epidemiology), UVSQ, Université Paris-Saclay, Hôpital Paul Brousse, Villejuif Cedex, France; Department of Nephrology, Ambroise Paré University Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Boulogne-Billancourt, France.
authors.forename: Ziad A
authors.initials: ZA
authors.lastname: Massy
mesh_terms: D058186:Acute Kidney Injury / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality / Q000628:therapy; D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D006801:Humans; D015994:Incidence; D017582:Renal Replacement Therapy; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000009:adverse effects* / Q000401:mortality