- About 200,000 people in the United States are affected by an abdominal aortic aneurysm (AAA) each year.
- Acute kidney injury is a known potential risk factor following surgical AAA repair.
- Researchers from Michigan Medicine have developed an algorithm to detect a person’s kidney damage risk before an endovascular AAA repair.
- Using their algorithm, scientists found women have a 1.4 times higher chance of developing acute kidney injury after an endovascular AAA repair.
Researchers from Michigan Medicine recently designed an algorithm that can be used by doctors before performing an endovascular AAA repair to measure a person’s risk for developing kidney damage.
After applying their new algorithm to the data of more than 7,000 people, the researchers reported that women are 1.4 times more likely than men to develop acute kidney injury after receiving endovascular AAA repair.
This study was recently published in the journal Annals of Vascular Surgery.
Acute kidney injury occurs when the function of the kidneys declines and they are no longer able to remove waste products from the body.
This causes a build-up of waste in the body, which can lead to long-term kidney damage and chronic kidney disease.
Doctors use the Kidney Disease Improving Global Outcomes (KDIGO) to determine whether a person has acute kidney injury.
The KDIGO uses specific measures of the body waste product creatinine to make this judgement. Signs of kidney injury include:
- an increase in serum creatinine of more than or equal to 0.3 milligrams per deciliter within 48 hours.
- an increase in serum creatinine of more than or equal to 1.5 times the baseline within the previous seven days.
- urine volume of less than 0.5 milliliters/kilogram/hour over six hours.
Symptoms of acute kidney injury include:
- infrequent urination
- problems breathing and/or chest pain
- swelling in the legs, ankles, and feet
Acute kidney injury is most common in people who are in a hospital’s
age— older adults 65 and over
- undergoing a
- overuse of
NSAIDs congestive heart failure
- history of kidney disease
- inflammation or damage to the
kidney tubules enlarged prostate
- kidney stones
certain cancers, including bladder, prostate, and cervical cancer
- severe dehydration
- serious infections
The renal arteries start at and branch off from the abdominal aorta. Because of that, anything affecting blood flow in the abdominal aorta may also impact the renal arteries feeding the kidneys.
In this study, researchers focused on a particular type of kidney damage called
Previous studies show acute kidney injury is a known
Researchers first developed an algorithm for doctors to use to identify a person’s risk for developing acute kidney injury after an endovascular AAA repair.
After designing the algorithm, they tested it using data from more than 7,000 people in the Blue Cross Blue Shield of Michigan Cardiovascular Consortium database.
Upon analysis, the research team reported that women had a 1.4 times higher chance of developing acute kidney injury after receiving endovascular AAA repair.
“While we have seen a higher risk of acute kidney injury in female patients who have undergone coronary stenting or renal stenting, this is the first time we are seeing a higher risk after endovascular abdominal aortic aneurysm repair,” said Dr. Peter Henke, a vascular surgeon and director of the University of Michigan Health Frankel Cardiovascular Center and senior author of this study.
Scientists also found people with a reduced glomerular filtration rate had a 4.7 times higher chance of developing acute kidney injury after aneurysm repair. Additionally, those with larger aneurysms also had a higher risk for kidney damage.
After reviewing this study, Dr. Adi Iyer, a neurosurgeon and interventional neuroradiologist of Pacific Neuroscience Institute at Providence Saint John’s Health Center in California, told Medical News Today that he found the study surprising because doctors generally do not think of gender as being a factor related to patient outcome.
“When you look at the
Iyer said there are a few ways these findings could help doctors in determining a person’s kidney damage risk prior to surgery.
“We would have to use our judgment in terms of how much contrast to use, consenting patients about the risk of kidney damage based on their sex, and just making sure patients have all the information of potential risks, and making sure that women know that they are slightly higher risk,” he said.
Medical News Today also spoke with Dr. Massimo M. Napolitano, the interim chair of the Department of Vascular Surgery at Hackensack University Medical Center in New Jersey, about this study.
“I was intrigued by the calculated higher risk among women for acute
“It will increase awareness of this higher-risk population and trigger a more focused pre-operative optimization of the patient,” Napolitano added.
As for the next steps in this research, Napolitano said as the researchers pointed out in the study, a clinical trial is needed to confirm their findings.
“In particular, I would like to see data on the pre-operative hydration status of the patients and how that affects CA-AKI,” he said. “I also believe the amount of contrast used is an important factor in developing this complication.”