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
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
Emergency & Critical Care Center, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, China
Department of Cardiovascular Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
Funds:
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).
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.