The Impact of Acute Renal Failure on Early and Late Outcomes After Thoracic Aortic Endovascular Repair Joseph D. Drews, BS, Himanshu J. Patel, MD, David.

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The Impact of Acute Renal Failure on Early and Late Outcomes After Thoracic Aortic Endovascular Repair Joseph D. Drews, BS, Himanshu J. Patel, MD, David M. Williams, MD, Narasimham L. Dasika, MD, G. Michael Deeb, MD The Annals of Thoracic Surgery Volume 97, Issue 6, Pages 2027-2033 (June 2014) DOI: 10.1016/j.athoracsur.2014.02.045 Copyright © 2014 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 This Kaplan-Meier analysis evaluates the risk for permanent renal replacement therapy. The 10-year freedom from dialysis in the entire cohort was 97.7% ± 1.1%. The Annals of Thoracic Surgery 2014 97, 2027-2033DOI: (10.1016/j.athoracsur.2014.02.045) Copyright © 2014 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 (A) The 10-year all cause late mortality in this cohort was 38.1% ± 6.3% by Kaplan-Meier analysis. (B) Late survival was reduced with occurrence of acute kidney injury (AKI), with the 10-year Kaplan-Meier survival for the group without AKI at 36.8% versus with AKI at 32.8% (Wilcoxon p < 0.001). (C) When this analysis was further stratified into class of AKI, 5-year survival was 67.2% for the group without AKI versus 56.3% for the risk class (Wilcoxon p = 0.001), 41.7% for the injury class (Wilcoxon p < 0.001), and 53.3% for the failure class (Wilcoxon p = 0.062). (D) Adjusted Cox regression analysis suggested that only the injury class (hazard ratio 4.0, p < 0.001) and failure class (hazard ratio 2.9, p = 0.04) were independently associated with late mortality. Note that the adjusted risk for mortality in (D) is not confined to the perioperative period. The steeper slopes of each respective curve for their full length suggests that these two higher stages of renal dysfunction have an ongoing contributing factor, increasing the overall force for mortality throughout the 5-year period. The Annals of Thoracic Surgery 2014 97, 2027-2033DOI: (10.1016/j.athoracsur.2014.02.045) Copyright © 2014 The Society of Thoracic Surgeons Terms and Conditions