Predictors of Decline in Renal Function 5 Years after EVAR

Area of Science:

• Vascular Surgery
• Nephrology
• Medical Device Technology

Background:

• Long-term renal function data after endovascular abdominal aortic aneurysm repair (EVAR) is limited.
• This study investigates predictors of renal function decline five years post-EVAR.

Purpose of the Study:

• To identify patient and procedural factors associated with a significant drop in glomerular filtration rate (GFR) 5 years after elective EVAR.
• To assess the long-term renal impact of EVAR.

Main Methods:

• Retrospective review of 143 patients undergoing elective EVAR between 2007-2015 with 5-year renal function follow-up.
• Analysis of baseline characteristics and procedural variables including fixation type, neck diameter, and contrast exposure.
• Primary outcome: >= 20% GFR drop at 5 years. Secondary outcome: progression to dialysis.

Main Results:

• Female gender (OR 3.9) and baseline renal insufficiency (OR 3.0) were significant independent predictors of a >= 20% GFR drop at 5 years.
• Univariate analysis also identified hypertension and supra-renal fixation as predictors.
• Only 2 patients (1.4%) progressed to dialysis by 5 years.

Conclusions:

• Female sex and pre-existing renal insufficiency are key risk factors for long-term renal function decline after EVAR.
• Supra-renal fixation may have a negative impact on renal function, particularly in at-risk populations.
• Further multi-center studies are warranted to explore avoiding supra-renal fixation in vulnerable female patients with baseline renal insufficiency.