EARLY RENAL DYSFUNCTION AFTER ELECTIVE SURGERY OF THE INFRARENAL AORTA - INCIDENCE AND PREDICTIVE FACTORS

Renal dysfunction was investigated in the early postoperative period in 223 patients subjected to surgery of the infrarenal aorta. Dysfunction was diagnosed as an elevation of creatinine plasma levels above 2 mg/dl in patients with normal preoperative renal function, or a 50% increase over abnormal preoperative levels, within the first 5 postoperative days. The overall incidence was 5,68% (13 patients), and 2 patients required hemodyalisis. Predictive variables were chronic hypertension and preoperative creatinine levels above 1,5 mg/dl. Two patients died from causes other than renal failure. No hemodynamic renal failure could be identified in 7 patients. The possibility of atheromatous renal embolization cannot be excluded in these patients. In patients with elevated risk for renal failure, delaying surgery after angiography, careful hemodynamic monitoring and surgical techniques may help decrease the incidence of this complication.