Mannitol and renal dysfunction after endovascular aortic aneurysm repair procedures: a randomized trial

Area of Science:

• Nephrology
• Vascular Surgery
• Pharmacology

Background:

• Endovascular aortic aneurysm repair (EVAR) poses a risk of renal function deterioration.
• Mannitol possesses properties that may protect the kidneys during EVAR.

Purpose of the Study:

• To evaluate the effect of mannitol on renal function following EVAR.
• To determine if mannitol can mitigate kidney injury in patients undergoing EVAR.

Main Methods:

• A randomized prospective study involving 86 patients undergoing elective EVAR.
• Patients received either hydration alone (controls) or hydration plus mannitol (0.5 g/kg).
• Renal function markers including creatinine, cystatin-C, and NGAL were measured at 24 and 72 hours post-procedure and at follow-up.

Main Results:

• Serum creatinine and cystatin-C were lower in the mannitol group at 24 hours post-EVAR.
• No significant differences in renal function markers were observed at 72 hours or long-term follow-up.
• While the mannitol group showed fewer patients with renal dysfunction by RIFLE criteria, the difference was not statistically significant.

Conclusions:

• Mannitol combined with hydration offers a modest but significant protective effect on renal function after EVAR.
• Mannitol may be a beneficial component in future strategies to preserve kidney function in EVAR patients.