Chronic renal insufficiency and risk of early mortality in patients undergoing carotid endarterectomy

Ann Vasc Surg. 2006 Sep;20(5):609-13. doi: 10.1007/s10016-006-9080-5. Epub 2006 May 31.

Abstract

We compared early outcome after carotid endarterectomy (CEA) in patients (n = 857 with 1,011 CEA interventions) with and without chronic renal insufficiency (CRI). Two groups were compared: a group with normal renal function (n = 909) and a group with CRI (creatinine >/=1.5 mg/dL and clearance of </=30 mL/min, as well as dialysis and transplant patients, n = 102). Mean age was significantly higher in CRI patients (71.22 vs. 68.33 years, p = 0.001). The incidence of smokers was 53.9% in the non-CRI group vs. 39.2% in CRI patients (p = 0.005). Hypertension (88.2% vs. 75.1, p = 0.003) and cardiac disease (58.8% vs. 47.4%, p = 0.029) were more common in the CRI group. The perioperative mortality rate was significantly higher in CRI patients (3.9% vs. 1.0%, p = 0.013). Multivariate logistic regression analysis showed a significant association between CRI and 30-day death rate (odds ratio = 3.76, p = 0.032). In this series, CRI patients presented an increased mortality. The mortality risk may be related to the increased rates of preoperative hypertension and coronary disease and perioperative myocardial infarction. A more reserved attitude seems indicated in planning CEA for patients with renal dysfunction in combination with a history of coronary artery disease.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Belgium / epidemiology
  • Carotid Stenosis / complications
  • Carotid Stenosis / mortality*
  • Carotid Stenosis / surgery*
  • Endarterectomy, Carotid / adverse effects*
  • Female
  • Heart Diseases / complications
  • Humans
  • Hypertension / complications
  • Incidence
  • Logistic Models
  • Male
  • Mortality / trends
  • Odds Ratio
  • Patient Selection
  • Prospective Studies
  • Renal Insufficiency, Chronic / complications
  • Renal Insufficiency, Chronic / mortality*
  • Risk Assessment
  • Risk Factors
  • Smoking / adverse effects
  • Stroke / epidemiology
  • Stroke / etiology*
  • Time Factors
  • Treatment Outcome