Surgical results of abdominal aortic aneurysm repair in patients with chronic renal dysfunction

The purpose of this study was to determine the influence of preoperative renal dysfunction on the outcome of patients undergoing elective, infrarenal abdominal aortic aneurysm (AAA) repair. Patients undergoing AAA repair from 1984 to 1996 (n = 250) were divided into 2 groups, according to their preoperative serum creatinine levels: > or = 1.5 mg/dl (group A, n = 33) and < 1.5 mg/dl (group B, n = 217). There was no apparent difference in the incidences of preoperative risk factors, excluding ischemic heart disease, between the groups. The mortality rates of the 2 groups did not differ (9.9% vs 3.2% in groups A and B, respectively, p = 0.13), but the morbidity rate of group A (30.3%) was significantly higher than that of group B (12.9%, p = 0.0095). The 5-year cumulative survival rate of group A patients was 60%, which was significantly lower (p < 0.0001) than that of group B patients (84%). Five group A patients underwent simultaneous renal artery reconstruction, which relieved postoperative renal deterioration in 4, although 2 of them developed chronic renal failure requiring hemodialysis over 5 years after the operation. These findings suggest that morbidity and long-term survival in patients with renal dysfunction can be severe after AAA repair and that simultaneous renal artery reconstruction may delay renal function decline.