The assessment of renal function following aortic surgery

• Main Author: Awad, Reda William
• Published: University of Leicester 1987
• Subjects: 620
• Online Access: http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.674167

Since the early days of infrarenal aortic reconstruction, renal failure has remained an important cause of post-operative morbidity and mortality. Biochemical testing of renal function following aortic surgery showed evidence of post-operative renal impairment in 47 to 60 per cent of patients. Biochemical testing of renal function is inaccurate. This study was undertaken to examine the immediate post-operative effects of aortic surgery on renal function and also the long term effects six months after surgery using radionuclide tests; which show minor changes of renal function not detectable biochemically and test the function of individual kidneys. Glomerular filtration rate (GFR) was measured using 51Cr labelled EDTA clearance. Effective renal plasma flow (ERPF) was measured using 125I labelled Hippuran clearance. The individual kidney function was assessed using a 99Tc labelled DMSA renal scanning and 99Tc labelled DTPA renography. Two age matched groups groups of patients were used as controls, 1. Patients with arteriopathy who were treated conservatively. 2. Patients undergoing major colonic resection. The control groups allowed comparison of those patients undergoing aortic surgery with a similar group of patients who suffered from the same disease but were treated without surgery. The second control group of patients undergoing major colonic surgery allowed comparison with those patients having aortic surgery. The radionuclide tests of renal function were carried out pre-operatively, 10 to 14 days post-operatively and six months later on all aortic patients. The control patients had the tests done twice. The results indicate that the changes in renal function are specific to aortic surgery. 40 per cent of patients when examined at six months showed a significant deterioration of their renal function. The effects of the operative parameters on the renal function are also discussed.