Suprarenal aortic cross-clamping and renal function

Renal failure occurs in 1-13% of abdominal aortic reconstructions. In our survey of 81 abdominal aortic aneurysms, out of 100 abdominal aortic operations, suprarenal cross-clamping was necessary in 4 cases, with 1 transient postoperative dialysis, followed by a fully restored renal function in 19th postoperative day. Among the cases with infrarenal aortic cross-clamping, one patient died owing to colonic infarction, another patient presented progressive and persistent renal damage. From our experience, literature results and knowledge about renal physiopathology, it must be stressed that during and after abdominal aortic operations not only the manouvres of supra or infrarenal aortic clamping, but also concomitant cardiac diseases, the share of body fluids, and consequent hydroelectrolytic changes could affect the renal function. All these factors, and not only the technical aspects, should be considered with the aim of doing a correct prevention of the postoperative renal failure.