The Nephrology Department, Xijing Hospital, The Fourth Military Medical University, Xi'an, PR China.
Department of Nephrology, State Key Laboratory of Kidney Disease, Chinese People's Liberation Army General Hospital and Military Medical Postgraduate College, Beijing, PR China.
Ren Fail. 2021 Dec;43(1):585-596. doi: 10.1080/0886022X.2021.1905664.
Type B aortic dissection is a rare but life-threatening disease. Thoracic endovascular aortic repair (TEVAR) was widely used for Type B aortic dissection patients in the last decade due to the lower mortality and morbidity compared with open chest surgical repair (OCSR). AKI in type B aortic dissection is a well-recognized complication and indicates poor short-term and long-term outcome. The objective of this concise review was to identify the risk factors and the impact of AKI on type B aortic dissection patients.
A literature search was performed using PubMed, Embase, MEDLINE, and Cochrane Library with the search terms 'type B aortic dissection' and 'acute kidney injury' (AKI), and all English-language literatures published in print or available online from inception through August 2020 were thoroughly reviewed. Studies that reported relative AKI risks and outcomes in type B aortic dissection patient were included. Major mechanisms of AKI in type B aortic dissection included renal hypoperfusion, inflammation response, and the use of contrast medium. Type B aortic dissection patients with AKI significantly had increased hospital stay duration, need of renal replacement therapy, and 30-d and 1-year mortality.
AKI in type B aortic dissection is a well-recognized complication and associated with poor short-term and long-term outcome. Early identification of high-risk patients, early diagnosis of AKI, stabilization of the hemodynamic parameters, avoidance of nephrotoxic drugs, and optimization of the use of contrast agents are the major strategies for the reduction of AKI in type B aortic dissection patients.
B 型主动脉夹层是一种罕见但危及生命的疾病。与开放性胸部手术修复（OCSR）相比，胸主动脉腔内修复术（TEVAR）在过去十年中被广泛用于 B 型主动脉夹层患者，因为其死亡率和发病率较低。B 型主动脉夹层中的急性肾损伤（AKI）是一种公认的并发症，表明短期和长期预后不良。本综述的目的是确定 B 型主动脉夹层患者 AKI 的危险因素及其对患者的影响。
使用 PubMed、Embase、MEDLINE 和 Cochrane Library 进行文献检索，检索词为“B 型主动脉夹层”和“急性肾损伤（AKI）”，并全面回顾了截至 2020 年 8 月通过印刷品或在线发布的所有英文文献。纳入了报告 B 型主动脉夹层患者相对 AKI 风险和结局的研究。B 型主动脉夹层中 AKI 的主要发生机制包括肾灌注不足、炎症反应和造影剂的使用。B 型主动脉夹层合并 AKI 的患者住院时间明显延长，需要肾脏替代治疗，30 天和 1 年死亡率增加。
B 型主动脉夹层中的 AKI 是一种公认的并发症，与短期和长期预后不良相关。早期识别高危患者、早期诊断 AKI、稳定血流动力学参数、避免肾毒性药物以及优化造影剂的使用是减少 B 型主动脉夹层患者 AKI 的主要策略。
