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2015 ; 87
(2
): 442-51
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gab.com Text
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A systematic review and meta-analysis indicates underreporting of renal
dysfunction following endovascular aneurysm repair
#MMPMID25140912
Karthikesalingam A
; Bahia SS
; Patel SR
; Azhar B
; Jackson D
; Cresswell L
; Hinchliffe RJ
; Holt PJ
; Thompson MM
Kidney Int
2015[Feb]; 87
(2
): 442-51
PMID25140912
show ga
Deterioration in renal function has been described after endovascular repair of
abdominal aortic aneurysms (EVRs). The etiology is multifactorial and represents
an important therapeutic target. A need exists to quantitatively summarize
incidence and severity of renal dysfunction after EVR to allow better-informed
attempts to preserve renal function and improve life expectancy. Here a
systematic search was performed using Medline and Embase for renal function after
EVR applying PRISMA statements. Univariate and multivariate random-effects
meta-analyses were performed to estimate pooled postoperative changes in serum
creatinine and creatinine clearance at four time points after EVR. Clinically
relevant deterioration in renal function was also estimated at 1 year or more
after EVR. Pooled probability of clinically relevant deterioration in renal
function at 1 year or more was 18% (95% confidence interval of 14-23%, I2 of
82.5%). Serum creatinine increased after EVR by 0.05?mg/dl at 30 days/1 month,
0.09?mg/dl at 1 month to 1 year, and 0.11?mg/dl at 1 year or more (all
significant). Creatinine clearance decreased after EVR by 5.65 ml/min at 1
month-1 year and by 6.58?ml/min at 1 year or more (both significant). Thus, renal
dysfunction after EVR is common and merits attention.