Baseline renal function and surgical revascularization in atherosclerotic renal arterial disease in the elderly
Luis Bedoya, MD
Michael Ziegelbaum, MD
Donald G. Vidt, MDAddress reprint requests to D.G.V., Department of Hypertension and Nephrology, The Cleveland Clinic Foundation, One Clinic Center, 9500 Euclid Avenue, Cleveland, Ohio 44195.
Kavita Badhwar, MA
Andrew C. Novick, MD
Ray W. Gifford, MD
From 1975 to 1984,107 patients ≥60 years of age had surgical revascularization at the Cleveland Clinic for correction of atherosclerotic renal arterial disease. To evaluate the effect of baseline renal function (RF) on outcome in older patients, the patients were retrospectively divided according to their preoperative serum creatinine levels into Group I, ≤1.4 (N=26), and Group II, ≥1.5 (N=81). Extrarenal atherosclerosis was more frequent in Group II (P<.005). Higher rates of complications were seen both in Group II and with extrarenal atherosclerosis, but these associations did not achieve statistical significance (P=.07). Baseline RF did not affect results, but after revascularization, the fall in diastolic blood pressure was greater in Group I (28.2 ± 4.4 mmHg v 17.4 ± 1.8 mmHg, P<.05). No such effect was noted in systolic blood pressure or in the frequency of cure or improvement v failure. Operative mortality for the entire group was 2.8%.