[Factors prognostic of acute kidney insufficiencies following vascular surgery]

Acute renal failure (ARF) following vascular surgery is still associated with high mortality and morbidity rates. A retrospective study of 33 patients, admitted in ICU for ARF following the surgical treatment of aortic occlusive or aneurysmal diseases, was undertaken to determine the risk factors, clinical settings and prognosis of postoperative renal failure. There were 29 men and 4 women, with a mean age of 63 years and SAPS of 18. The surgical procedure was scheduled in more than 50% of the cases. The mortality rate was extremely high (79%); only 4 out of 33 patients were discharged without sequelae. History and clinical settings had addictive effects for the development of postoperative renal failure. Most patients who had sustained oliguria or who developed septic shock or multiple organ failure were associated with poor prognosis. The conclusion is that the prognosis of acute renal failure after vascular surgery depends more on the occurrence of multiple organ failure than the acute renal failure by itself.