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Aim:   To compare the effect of open and endovascular repair on renal function.Materials and methods:   In a prospective, non-randomized study twenty-four abdominal aortic aneurysms (AAA) treatable with either method were repaired, 15 using endovascular device (ENDO group) and nine with open surgery with infrarenal aortic cross-clamping (OPEN group). All the patients had standardised general anaesthesia, intravascular fluid therapy and monitoring. Renal function tests and cardiovascular measurements were performed at predetermined intervals.Results:   N-acetyl-β-D-glucosaminidase indexed to urinary creatinine (U-NAG/crea), sensitive marker of renal proximal tubular damage, increased similarly in both groups at the end of surgery (two-way ANOVA, p &lt; 0.05). No patient developed clinical renal impairment, on the contrary, creatinine clearance was increased, serum cystatin C (a sensitive marker of renal glomerular filtration) and serum creatinine concentration decreased at 24 hours postoperatively (Wilcoxon paired test, p &lt; 0.05). Intraoperative blood loss and the amount of administered crystalloids were higher in the OPEN than in the ENDO group (Mann-Whitney U-test, p &lt; 0.05). The cardiovascular measurements were comparable between the groups. The mean (SD) amount of radio-contrast media given was 3.1 (1.1) ml/kg in the ENDO group.Conclusions:   Our results indicate that endovascular AAA repair does not protect renal proximal tubular function. A temporary renal tubular dysfunction was found both in open and in endovascular AAA repair which did not lead to permanent changes in renal function.

Endovascular vs Open AAA Repair: Similar Effects on Renal Proximal Tubular Function