Textor SC, Hallett JW, Kos PB, Schneider CL, Nicpon ,
Schirger A
Outcomes and risks of renal revascularization in azotemic
atherosclerotic patients
Am Soc Nephrol
J Am Soc Nephrol (abstract)
(Nov) 6:405 1995
A retrospective review of 304 patients with baseline renal insufficiency
(creatinine > 2.0 mg/dL) who had undergone renal revasculaization surgery was
performed. 3/4 of patients also underwent aortic repair. In 27%, creatinine
fell
after surgery, whereas in 21% it rose. In 52% renal function did not change.
Blood pressure was easier to control but not cured. Median hospital stay was
17
days, and median hospital charges in 1993 $ were 38,500. Median survival was
4.4
years. 30 day mortality was approximately 10% and was higher for age > 70,
pre-operative creatinine > 3.0, and aortic repair. Given the high costs and
limited effect on survival, the authors believe that patients should be more
highly selected for renal revascularization than was previous custom.
(Paller)
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Am Soc Nephrol
H: Special problems :
Renovascular hypertension