Chronic Kidney Disease Class Predicts Mortality After Abdominal Aortic Aneurysm Repair in Propensity-matched Cohorts From the Medicare Population

Abstract

CKD severity is an important predictor of perioperative mortality and long-term survival after AAA repair in propensity-matched cohorts. The 5-fold increase in 30-day mortality and 44% in 3-year survival suggest that elective AAA repair is contraindicated in most severe CKD patients.

Late outcomes of endovascular aortic stent graft therapy in patients with chronic kidney disease

“…The same institution published another extensive investigation using a Medicare database, by far the most massive in sample size, and demonstrated a 2-fold increase in mortality in patients with moderate CKD and a 6-fold increase in mortality in patients with severe CKD receiving open or endovascular repair of AAA. [ 14 ] Our findings not only showed that preoperative CKD significantly connected with higher mortality and complications after EVAR, which agrees with the previous publications, but further point out the unsatisfactory outcome of ESRD patients. The study by Komshian et al, [ 30 ] which included over 28,000 patients using Vascular Quality Initiative database data, also showed that ESRD was independently associated with higher perioperative mortality (7% vs 2.4%) and lower 1-year survival (78% vs 94%) rates.…”

“…[ 13 ] Studies have shown that patients with CKD who underwent open aortic repair exhibited poorer outcomes than other patients. According to the study conducted by Aranson et al, [ 14 ] —which included more than 47,000 patients and is by far the most extensive study examining CKD severity survival and postoperative complications after elective abdominal aortic aneurysm (AAA) repair (open and endovascular approach)—CKD caused a 5-fold increase in 30-day mortality. For thoracic aortic disease, Marrocco-Trischitta et al [ 15 ] showed that glomerular filtration rate is an accurate prognostic predictor in patients submitted to TEVAR.…”

Intrarenal arterial administration of human umbilical cord-derived mesenchymal stem cells effectively preserved the residual renal function of diabetic kidney disease in rat

“…Plentiful data from clinical observational studies have clearly revealed that CKD contributed high morbidity and mortality in hospitalized patients, especially in those CKD patients with coexisting cardiovascular disease (i.e., cardiorenal syndrome) [ 1 – 6 ]. Surprisingly, despite the state-of-the-art therapeutic and advanced pharmaceutical strategies, such as the uses of angiotensin-converting enzyme inhibitor (ACEI), angiotensin II type I receptor blockade (ARB), direct renin inhibitor (DRI) and good education regarding how to avoid damage of kidney as well as renewed guidelines for CKD precise management, progressive deterioration of kidney function still inevitably occurs in a majority of CKD patients, subsequently progresses into end-stage renal disease (ESRD) in these patients [ 7 – 10 ].…”

Investigated the safety of intra-renal arterial transfusion of autologous CD34+ cells and time courses of creatinine levels, endothelial dysfunction biomarkers and micro-RNAs in chronic kidney disease patients-phase I clinical trial

“…Abundant data from clinical observational studies have revealed that CKD contributed high morbidity and mortality in hospitalized patients, especially in those CKD patients with co-existing cardiovascular disease (i.e., cardiorenal syndrome) [10–14]. Surprisingly, despite the state-of-the-art therapeutic and advanced pharmaceutical strategies, such as the uses of angiotensin converting enzyme inhibitor (ACEI), angiotensin II type I receptor blockade (ARB), and direct renin inhibitor (DRI), as well as good education, and renewed guideline for CKD precise management, progressive deterioration of renal function is frequently observed, subsequently leading to the adverse development of end-stage renal disease (ESRD) in CKD patients [15–20].…”