Department of Nephrology, Hippokration Hospital, Aristotle University of Thessaloniki, Konstantinoupoleos 49, Thessaloniki GR54642, Greece.
Department of Cardiothoracic Surgery-Division of Cardiac Surgery, Münster, University Hospital, Universitätsklinikum, Münster, Germany.
Cardiovasc Res. 2022 Sep 20;118(12):2582-2595. doi: 10.1093/cvr/cvab287.
Chronic kidney disease (CKD) is an independent risk factor for the development of abdominal aortic aneurysm (AAA), as well as for cardiovascular and renal events and all-cause mortality following surgery for AAA or thoracic aortic dissection. In addition, the incidence of acute kidney injury (AKI) after any aortic surgery is particularly high, and this AKI per se is independently associated with future cardiovascular events and mortality. On the other hand, both development of AKI after surgery and the long-term evolution of kidney function differ significantly depending on the type of AAA intervention (open surgery vs. the various subtypes of endovascular repair). Current knowledge regarding AAA in the general population may not be always applicable to CKD patients, as they have a high prevalence of co-morbid conditions and an elevated risk for periprocedural complications. This summary of a Kidney Disease: Improving Global Outcomes Controversies Conference group discussion reviews the epidemiology, pathophysiology, diagnosis, and treatment of Diseases of the Aorta in CKD and identifies knowledge gaps, areas of controversy, and priorities for future research.
慢性肾脏病（CKD）是腹主动脉瘤（AAA）发展的独立危险因素，也是 AAA 或胸主动脉夹层手术后心血管和肾脏事件以及全因死亡率的独立危险因素。此外，任何主动脉手术后发生急性肾损伤（AKI）的发生率特别高，而这种 AKI 本身与未来的心血管事件和死亡率独立相关。另一方面，手术后 AKI 的发展和肾功能的长期演变因 AAA 干预的类型（开放手术与各种血管内修复亚型）而有很大差异。一般人群中关于 AAA 的现有知识可能并不总是适用于 CKD 患者，因为他们合并症的患病率很高，围手术期并发症的风险也很高。本次肾脏病：改善全球预后组织争议会议小组讨论回顾了 CKD 中主动脉疾病的流行病学、病理生理学、诊断和治疗，并确定了知识空白、争议领域和未来研究的重点。
