K WT CHAU1, N DULLAGHAN1, S BHUTIA2
1Department of Medicine, Cairns Hospital, Cairns, Australia, 2Cairns Vascular Unit, Cairns Hospital, Cairns, Australia
Aim: To determine the incidence of Acute Kidney Injury (AKI) and its contributing risk factors, in patients receiving endovascular aneurysm repair (EVAR) in regional Far North Queensland.
Background: AKI may be associated with EVAR and more insight into the potential risk factors is needed to optimize patient outcome.
Methods: All patients who underwent EVAR in Cairns Hospital between 1st January 2015 to 28th February 2020 were included. Their surgical parameters and clinical course are defined using local public health system data. The primary endpoint was incidence of AKI as per the “Acute Kidney Injury Network” (AKIN), and “Kidney Disease Improving Global Outcomes” (KDIGO) criteria. Subgroup analysis was carried out to study difference in characteristics between AKI and non-AKI group.
Results: 59 patients were identified, 3 were excluded due to death peri-operatively or on haemodialysis at time of surgery. 9/56 (16%) patients developed AKI within 1 week post EVAR, of which mean contrast volume used was 173mls (95% CI 74-272mls), compared to 117mls (95% CI 103-131mls) in non-AKI group (p=0.01). Angiotensin Converting Enzyme Inhibitor (ACE-i) or Angiotensin Receptor Blocker (ARB) use was more prevalent in the AKI group – 5/9 (56%) vs 20/47 (43%) (p=0.49). Mean age (72 years) and Median hospital stay (3 days) were comparable between two groups. 6/9 (67%) in AKI group received suprarenal fixation of stent in EVAR, compared to 37/47 (79%) in non-AKI group (p=0.42).
Conclusions: Incidence of AKI in EVAR patients in FNQ is comparable to other centres. Suprarenal fixation of stents does not appear to increase incidence of AKI. AKI is associated with higher volume contrast use and ACE-i/ARB use, but does not result in overall increased hospital stay.
Ken Chau is a medical registrar working at Cairns Base Hospital. He graduated from Queens’ University of Belfast, previously working and trained at United Kingdom before continuing his medical training at Australia. He has a keen interest in research, currently working on a few projects including Rheumatic Heart Disease in Far North Queensland and Acute Kidney Injury in patients receiving vascular interventions.