A systematic review and meta-analysis indicates underreporting of renal dysfunction following endovascular aneurysm repair

作者：Karthikesalingam Alan; Bahia Sandeep S; Patel Shaneel R; Azhar Bilal; Jackson Dan; Cresswell Lynne; Hinchliffe Robert J; Holt Peter J E^*; Thompson Matt M

来源：Kidney International, 2015, 87(2): 442-451.

DOI：10.1038/ki.2014.272

• creatinine
• creatinine clearance
• kidney dysfunction
• renal dysfunction
• vascular
• vascular disease

Deterioration in renal function has been described after endovascular repair of abdominal aortic aneurysms (EVRs). The etiology is multifactorial and represents an important therapeutic target. A need exists to quantitatively summarize incidence and severity of renal dysfunction after EVR to allow better-informed attempts to preserve renal function and improve life expectancy. Here a systematic search was performed using Medline and Embase for renal function after EVR applying PRISMA statements. Univariate and multivariate random-effects meta-analyses were performed to estimate pooled postoperative changes in serum creatinine and creatinine clearance at four time points after EVR. Clinically relevant deterioration in renal function was also estimated at 1 year or more after EVR. Pooled probability of clinically relevant deterioration in renal function at 1 year or more was 18% (95% confidence interval of 14-23%, I-2 of 82.5%). Serum creatinine increased after EVR by 0.05 mg/dl at 30 days/1 month, 0.09 mg/dl at 1 month to 1 year, and 0.11 mg/di at 1 year or more (all significant). Creatinine clearance decreased after EVR by 5.65 ml/min at 1 month-1 year and by 6.58 ml/min at 1 year or more (both significant). Thus, renal dysfunction after EVR is common and merits attention.

• 出版日期2015-2