Abstract
Objectives:To evaluate the effect of superselective renal artery embolization in terms of renal function and blood pressure, to compare the results between groups with different embolization extents, and to analyze risk factors of entire study population for postprocedural acute kidney injury (AKI).Materials and Methods:The inclusion criteria were patients who underwent renal artery embolization from January 2009 to December 2019, with available serum creatinine and blood pressure data. The exclusion criteria were non-selective embolization of main renal artery, AKI before embolotherapy, and follow-up of less than one month. According to the extent of embolization, the patients were divided into two groups: Group A (1 segment) and Group B (2–4 segments).Results:A total of 48 patients were enrolled. There was a significant difference between pre- and postprocedural estimated glomerular filtration rate (p = 0.030). There were no significant difference between pre- and postprocedural blood pressure. The incidence of postprocedural AKI in group B was significantly higher than that in group A (p = 0.044). There was no significant difference in the incidence of the worsening of hypertension between the two groups. Chronic kidney disease and high embolization grade were predictive for postprocedural AKI (p = 0.012, 0.021).Conclusion:Superselective embolization appears to be a safe procedure, but meticulous attention for AKI is required for patients who underwent embolization of more than one segmental artery. An attempt to minimize the extent of devascularization should be pursued to avoid postprocedural complications.
Highlights
Renal artery embolization (RAE) is a minimally invasive therapeutic option that can be used to treat a variety of conditions
Risk factors for postprocedural acute kidney injury (AKI) In the multivariable binary logistic analysis of entire study population, Chronic kidney disease (CKD) (OR: 35.67, 95% CI: 2.22–572.50, p = 0.012) and embolization grade 2 (OR: 48.53, 95% CI: 1.79–1318.57, p = 0.021) were predictive of postprocedural AKI (Table 4)
Our study demonstrated a significant postprocedural decrease in estimated glomerular filtration rate (eGFR) in the overall study group (–4.7 ± 17.57 mL/min/1.73 m2, p = 0.030) and in group B (–9.22 ± 17.45 mL/min/1.73 m2, p = 0.019)
Summary
Renal artery embolization (RAE) is a minimally invasive therapeutic option that can be used to treat a variety of conditions. A few previous studies have found RAE to be a safe procedure, but renal failure and hypertension (HTN) are possible alarming complications [1,2,3]. The current single-institution study aimed to evaluate the effect of superselective RAE in terms of renal function and blood. § Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, KR. ‖ Clinical Trial Center, Soonchunhyang University College of Medicine, Cheonan Hospital, Cheonan-si, KR pressure, to compare clinical outcomes between groups with different embolization extents, and to investigate risk factors of the entire study population for postprocedural acute kidney injury (AKI)
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