EVALUATION OF EARLY POSTOPERATIVE KIDNEY DYSFUNCTION IN PATIENTS UNDERGOING ELECTIVE OPEN ABDOMINAL AORTIC ANEURYSM REPAIR WITH INTRAOPERATIVE HYPOTENSION AND CONTINUOUS VASOPRESSOR SUPPOR
DOI:
https://doi.org/10.67214/89kw2162Keywords:
acute kidney dysfunction, abdominal aortic aneurysm, intraoperative hypotension, vasopressor supportAbstract
Background: Development of postoperative kidney dysfunction is one of the most common and serious perioperative complications in patients undergoing open abdominal aortic aneurysm (AAA) repair resulting from several factors. In this context, intraoperative hypotension and the subsequent need for vasopressor support are associated with postoperative kidney dysfunction, although their individual contributions are difficult to distinguish.
Objectives: To evaluate early postoperative renal-function changes in patients who required continuous intraoperative norepinephrine infusion to treat hypotension.
Methods: A prospective observational cohort study included 20 patients undergoing elective open abdominal aortic aneurysm repair. Patients were divided into two groups according to the intraoperative need for continuous norepinephrine infusion. Intraoperative hemodynamic parameters, acid-base status, and postoperative renal function markers were analyzed and compared between the groups.
Results: Patients receiving intraoperative norepinephrine infusion had significantly lower minimum mean arterial pressure values compared with patients without vasopressor support (61.5 vs. 75.75 mmHg, p<0.005). Significantly higher serum creatinine levels (124.5 vs. 79.88 μmol/L, p=0.03) and significantly lower 24-hour urine output (1700 vs. 2450 mL, p=0.002) were observed in the norepinephrine group 48 hours following surgery.
Conclusion: Patients requiring intraoperative vasopressor support during open abdominal aneurysm repairexperience higher level of hemodynamic instability, more severe hypotension, and less favorable early postoperative kidney dysfunction markers. However, these findings cannot establish direct adverse renal dysfunction effects.
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Copyright (c) 2026 Angela Trposka Poposka, Biljana Kuzmanovska, Marija Jovanovski Srceva, Filip Naumovski, Albert Leshi, Katerina Stavrik (Author)
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