{"doi":"10.1016/j.sopen.2023.06.001","title":"Bilateral renal artery stenosis impacts postoperative complications after major vascular surgery","abstract":"Background: Incidental atherosclerotic renal artery stenosis (RAS) is common in patients undergoing vascular surgery and has been shown to be associated with postoperative AKI among patients undergoing major non-vascular surgeries. We hypothesized that patients with RAS undergoing major vascular procedures would have a higher incidence of AKI and postoperative complications than those without RAS. Methods: A single-center retrospective cohort study of 200 patients who underwent elective open aortic or visceral bypass surgery (100 with postoperative AKI; 100 without AKI) were identified. RAS was then evaluated by review of pre-surgery CTAs with readers blinded to AKI status. RAS was defined as ≥50 % stenosis. Univariate and multivariable logistic regression was used to assess association of unilateral and bilateral RAS with postoperative outcomes. Results: 17.4 % (n = 28) of patients had unilateral RAS while 6.2 % (n = 10) of patients had bilateral RAS. Patients with bilateral RAS had similar preadmission creatinine and GFR as compared to unilateral RAS or no RAS. 100 % (n = 10) of patients with bilateral RAS had postoperative AKI compared with 45 % (n = 68) of patients with unilateral or no RAS (p < 0.05). In adjusted logistic regression models, bilateral RAS predicted severe AKI (OR 5.82; CI 1.33, 25.53; p = 0.02), in-hospital mortality (OR 5.71; CI 1.03, 31.53; p = 0.05), 30-day mortality (OR 10.56; CI 2.03, 54.05; p = 0.005) and 90-day mortality (OR 6.88; CI 1.40, 33.87; p = 0.02). Conclusions: Bilateral RAS is associated with increased incidence of AKI as well as in-hospital, 30-day, and 90-day mortality suggesting it is a marker of poor outcomes and should be considered in preoperative risk stratification.","journal":"Surgery Open Science","year":2023,"id":408525,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":0,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9391,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2023-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":671579,"name":"Shunshun Miao","orcid":null,"position":1,"is_corresponding":false},{"id":670727,"name":"Yuanfang Ren","orcid":"0000-0002-4716-2408","position":2,"is_corresponding":false},{"id":297259,"name":"Tezcan Ozrazgat‐Baslanti","orcid":"0000-0002-1158-9928","position":3,"is_corresponding":false},{"id":1052739,"name":"Sara Hensley","orcid":"0000-0001-7714-5951","position":4,"is_corresponding":false},{"id":383415,"name":"Christopher R. Jacobs","orcid":"0000-0001-7089-2428","position":5,"is_corresponding":false},{"id":1066619,"name":"M. Libby Weaver","orcid":"0000-0001-8947-4613","position":6,"is_corresponding":false},{"id":307195,"name":"Gilbert R. Upchurch","orcid":"0000-0002-4679-8623","position":7,"is_corresponding":false},{"id":108937,"name":"Azra Bihorac","orcid":"0000-0002-5745-2863","position":8,"is_corresponding":false},{"id":962654,"name":"Michol A. Cooper","orcid":null,"position":9,"is_corresponding":false},{"id":502516,"name":"Amanda C. Filiberto","orcid":"0000-0003-3586-8830","position":0,"is_corresponding":true}],"reference_count":35,"raw_metadata":null,"created_at":"2026-07-19T01:21:18.414003Z","pmid":"37409074","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}