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Assessment of Vascular Function in Patients With Chronic Kidney Disease
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Prevalent cardiac, renal and cardiorenal damage in patients with advanced abdominal aortic aneurysms

Chiara Barisione1, Silvano Garibaldi1, Claudio Brunelli1

  • 1Division of Cardiology, IRCCS San Martino University Hospital-IST, Research Center of Cardiovascular Biology, University of Genova, Viale Benedetto XV, 6., 16132, Genova, Italy.

Internal and Emergency Medicine
|October 30, 2015
PubMed

Insights

Patients with abdominal aortic aneurysms (AAA) frequently have cardiac damage (CD) and chronic kidney disease (CKD), often undiagnosed. Early identification and treatment of these conditions, along with iron deficiency and anemia, are crucial before surgery.

Area of Science:

  • Cardiology
  • Nephrology
  • Vascular Surgery

Background:

  • Chronic kidney disease (CKD) and cardiac damage (CD) increase risks in vascular surgery patients.
  • Abdominal aortic aneurysms (AAA) are associated with significant cardiovascular and renal comorbidities.

Purpose of the Study:

  • To determine the prevalence of cardiac damage (CD), chronic kidney disease (CKD), and cardiorenal syndrome (CRS) in patients undergoing AAA repair.
  • To assess the frequency of anemia and iron deficiency (ID) in this patient cohort.

Main Methods:

  • 563 patients with AAA undergoing cardiac screening before endovascular (EVAR) or open surgery (OS) were analyzed.
  • CD was defined by ACC/AHA CHF classification, CKD by CKD-EPI (GFR <60 mL/min/1.73 m²).
  • Anemia and ID were assessed using WHO and CHF criteria.

Main Results:

  • Prevalence of isolated CD was 24.1%, isolated CKD was 15.0%, and combined cardiorenal damage (CRS) was 20.6%.
  • Iron deficiency (ID) prevalence was 23.4%.
  • Anemia frequency increased from 12.8% in no risk factors (NoRF) to 38.8% in CRS patients, with many cases unrecognized.

Conclusions:

  • Unselected AAA patients exhibit high rates of cardiac and kidney damage, alongside high ID/anemia prevalence.
  • Improved identification and management of ID, anemia, CKD, and CD are essential pre-operatively for AAA patients.
  • These findings highlight the need for comprehensive pre-surgical evaluation in AAA patients to mitigate risks associated with cardiorenal comorbidities.

Keywords:
Abdominal aortic aneurysmAnemiaCardiac damageCardiorenal syndromeChronic kidney disease

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