variable, or proximal endograft landing zone was above the superior mesenteric artery. The primary outcome was postoperative dialysis. Secondary outcomes were 30-day mortality, dialysis at follow-up, postoperative renal function, and complications. Multivariate analysis was used to examine independent predictors of postoperative dialysis. Overall survival analysis was performed using Kaplan-Meier log-rank test.Results: Of the 54,020 patients in the two registries, 25,127 met criteria for analysis (24,828 without renal artery coverage, 215 CR, 84 CNR). Age, body mass index, race, ethnicity, and comorbidities did not differ between groups. CNR patients were more likely to present with ruptured (5.6% vs 6% vs 33.3%; P < .001) or symptomatic (8.5% vs 8.8% vs 11.9%; P < .0001) aneurysms. Postoperative dialysis was higher in CNR patients (0.7% vs 2.8% vs 18.5%; P < .0001) as were other postoperative complications (Table I). CNR had increased 30-day mortality and a higher need for dialysis at follow-up (Table I). On multivariate logistic regression, CNR and CR were significant independent predictors of postoperative dialysis after correcting for other significant covariates. Other independent predictors of postoperative dialysis included lower preoperative estimated glomerular filtration rate, lower body mass index, ruptured or symptomatic presentation, longer fluoroscopy time, need for blood transfusion, and larger blood loss (Table II). Overall survival at 2 years was significantly lower for CNR compared with the other groups (90.4% vs 88.5% vs 72.6%; P < .0001).Conclusions: Coverage of a renal artery without revascularization is highly predictive of the need for postoperative and permanent dialysis following EVAR. Renal artery CNR results in lower overall survival and should be avoided if at all possible.
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