ISSN 1671-5411 CN 11-5329/R

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Xiao WANG, Hong-Mei REN, Chun-Yan HU, Bin QUE, Hui AI, Chun-Mei WANG, Li-Zhong SUN, Shao-Ping NIE. Predictors and in-hospital outcomes of preoperative acute kidney injury in patients with type A acute aortic dissection. J Geriatr Cardiol 2016; 13(8): 679-684. doi: 10.11909/j.issn.1671-5411.2016.08.006
Citation: Xiao WANG, Hong-Mei REN, Chun-Yan HU, Bin QUE, Hui AI, Chun-Mei WANG, Li-Zhong SUN, Shao-Ping NIE. Predictors and in-hospital outcomes of preoperative acute kidney injury in patients with type A acute aortic dissection. J Geriatr Cardiol 2016; 13(8): 679-684. doi: 10.11909/j.issn.1671-5411.2016.08.006

Predictors and in-hospital outcomes of preoperative acute kidney injury in patients with type A acute aortic dissection

doi: 10.11909/j.issn.1671-5411.2016.08.006
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This study was supported in part by grants from the Beijing Natural Science Foundation (7141003), Beijing Municipal Science & Technology Commission (Z14110700 2514014), and Beijing Municipal Administration of Hospitals Incubating Program (PX2016048).

  • Received Date: 2015-11-09
  • Rev Recd Date: 2016-06-05
  • Publish Date: 2016-08-28
  • Background Acute kidney injury (AKI) is common after surgery for acute aortic dissection (AAD) and increases in-hospital and long-term mortality. However, few data exist on the clinical and prognostic relevance of early preoperative AKI in patients with type A AAD. We aimed to determine the incidence and predictors of preoperative AKI and the impact of AKI on in-hospital outcomes in patients with type A AAD. Methods From May 2009 to June 2014, we retrospectively enrolled 178 patients admitted to our hospital within 48 h from symptom onset and receiving open surgery for type A AAD. The patients were divided into no AKI and AKI groups and staged with AKI severity according to the KDIGO criteria before surgery. Results AKI occurred in 41 patients (23.0%). The incidence of in-hospital complications was significantly higher in patients with preoperative AKI compared to no AKI (41.5% vs. 9.5%, P vs. 0, P = 0.012), and it increased with AKI severity (Ptrend vs. 5.1%, P = 0.079). Multivariate analysis indicated that male gender, diastolic blood pressure on admission and bilateral renal artery involvement were independent predictors of preoperative AKI in patients with type A AAD. Conclusions Early AKI before surgery was common in patients with type A AAD, and was associated with increased in-hospital complications. Male gender, diastolic blood pressure on admission and bilateral renal artery involvement were major predictors for preoperative AKI.
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