Abdominal aortic aneurysm with kidney issues

Hello @shaheenn and welcome to Connect. It is so good to hear that you are helping your brother with his medical problems. Being a health care advocate is an important role these days. It really is important for all of us to have advocates who are watching out for us and seeking the best treatment possible.

You pose a good question about which route to go. I can certainly understand your concerns no matter which decision you make. On Mayo Connect, we are not medical professionals and therefore cannot suggest the best solution for your brother. However, there may be others in the Connect community who will offer comments. As we wait for others to comment I've posted some discussions we have on aortic aneurysms on Connect. Perhaps these discussions might provide some perspective.
https://connect.mayoclinic.org/discussion/aortic-aneurism-and-hip-replacement/
https://connect.mayoclinic.org/discussion/ascending-aortic-aneurysm-and-exercise/
https://connect.mayoclinic.org/discussion/pending-surgery-for-ascending-aortic-aneurysm-5-2-prior-open-heart-at/
I would also like to invite Ginger, @gingerw, to this discussion. While she does not have an aneurysm, she does have kidney problems and has had to adjust to concerns about using contrast.

While you have had two opinions from good vascular surgeons, I'm wondering if a third opinion from a teaching hospital (like a university medical school) or a facility like Mayo, might provide you with a bit more confidence in which path to follow.

Have you considered getting one more opinion?

Hello Teresa @hopeful33250, thank you so much for your prompt kind response with suggestions. I will read the threads you forwarded. A great suggestion on seeking a third opinion in regards to the options! I will pursue this as well.

I'm looking forward to hearing from you again, @shaheen.

Please let me know of any concerns or questions you have. Will you post again when you find a medical center for your next opinion?

To keep this short, I will try to give you as much of my AAA repair as possible. My AAA is several inches below my heart. It was repaired with an upside down “Y” shaped stent. Each short part of the Y went down my legs and the long part up towards the heart. It was repaired in 2011, the procedure went smoothly and checked every year since. Every 3 months the first two years, then bi-yearly for two years and every year since. Every thing always looks great, no leakage, no damage.

Now for my kidneys and creatinine numbers, since I have access to all my test results, bloodwork included. Three weeks before my procedure my kidneys were in great shape, filtration rate of 60 (excellent). Creatinine was at 0.7. Two days before my procedure, the numbers are almost the same, 60 & 0.9. Since the the procedure, my kidneys have been a disaster. In 2022, I’m constantly in 3rd stage CKD with my creatinine numbers well above normal, my filtration rate not far from needing dialysis. But I caution you not to jump to any conclusions. That’s because over the last 11 years, a number of mishaps, misdiagnosed damage caused by a well meaning doctor who prescribed a well known medication that literally put holes in my kidneys, damaging them. I have had trouble with stomach acid and a well know medicine for it caused calcium stones which damaged my kidneys and ended up with cysts in both kidneys.

There are other reasons and problems for my kidneys and today it’s a struggle to try and help them. My last Creatinine was 1.7 with a filtration of only 38. So my advice would be to have the procedure that will help him survive it. The complications sheet I had to sign stated 12 reasons I might die from the procedure (not good huh). Four would kill me right on the operating table, 4 would kill me in the recovery room and the last4 would kill me in less than two weeks!!! Now I don’t know if his procedure will be as dangerous as mine was but the way life is, his kidneys could be damaged from unknown causes in his future like mine has. I wish him good luck.

@shaheenn Welcome to Mayo Clinic Connect! I see you have had a few responses already, and @hopeful33250 has asked me to give my thoughts.

I don't have an abdominal aneurysm, but am in Stage 5 kidney failure. If the doctors have not given him the eGFR number [the filtration rate percentage] that would be helpful. In the past two years I have had several imaging procedures done, and even when the doctors ordered no contrast, I double checked with the technicians to make sure it was "no contrast". Impaired kidney function can be further hurt with the contrast material, because it is difficult for the kidneys to clear it out of your system. As @becky1024 told us, and we can each have different experiences.

If your brother does not have a nephrologist on his medical team, it might be a good thing to get an opinion from one before the procedure. Having good communication is critical, and understanding the pros and cons fully will help give him a basis for his decision.

Here is an article from the National Kidney Foundation about contrast dyes and our kidneys: https://www.kidney.org/atoz/content/Contrast-Dye-and-Kidneys#:~:text=CIN%20is%20a%20rare%20disorder,receiving%20dyes%20can%20develop%20CIN.
Let me know if I can help further and answer any questions.
Ginger

My procedure took so long because of the 3 connections needed in the upside down “Y”. One for the aorta and one for each leg. With so many things that could go wrong, I literally expected to die. So just as I was about to go under, I told my family I was going to be with them soon because they’re all dead.

The strangest thing I remember is this warm feeling all over my body, I thought I went to that place down there, instead of up. Because I was unconscious for so long and the temperature in the operating room was so cold, they had to wrap me in a warming blanket that surrounds your entire body with warm air constantly being blowing threw the blanket. It was a complicated procedure but I made it safely threw 11 years. My vascular surgeon is the chief doctor of the entire department. He compliments me every time he sees me and tells me my stent is the best work he’s ever done, Nice to know, huh?