Wu Tingting, Li Rui, Chen Jing, Tian Xiaqiu, Zhang Ran, Hou Xiaotong
Center for Cardiac Intensive Care, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, China.
Department of Health Care, China-Japan Friendship Hospital, Beijing, China.
Ren Fail. 2025 Dec;47(1):2444401. doi: 10.1080/0886022X.2024.2444401. Epub 2025 Jan 13.
The incidence of acute kidney injury (AKI) increases after surgical aortic valve replacement (SAVR). This study aimed to characterize the risk factors of AKI after SAVR.
We conducted a retrospective registry study based on data from 299 consecutive patients undergoing SAVR. At 48 h after SAVR, 41 patients developed AKI. There was a significantly higher prevalence of older age, higher body mass index (BMI), and diabetes mellitus in the AKI group. Previous use of angiotensin-converting enzyme inhibitors/angiotensin receptor blocker (ACEI/ARB) and β-blocker, intake and output volumes within 24 h, mechanical ventilation time, length of intensive care unit and hospital stay, baseline creatinine, baseline, 24 h, and 48 h estimated glomerular filtration rate were strongly associated with the incidence of AKI. BMI >24, history of hypertension, use of ACEI/ARB and β-blocker, and mechanical ventilation time were associated with AKI. Univariate logistic regression indicated that overweight, hypertension, use of ACEI/ARB and β-blocker, and mechanical ventilation time were associated with AKI. Notably, the ACEF score was an independent predictor of AKI. The receiver operating characteristic curve was employed to assess the ACEF score for predicting AKI and the best cutoff was 1.1. After dividing ACEF into quartiles, each one-unit increment in ACEF led to a 2.27-fold risk in the incidence of AKI among patients.
AKI is a generalizable phenomenon occurring frequently after SAVR. The ACEF score is an independent predictor of AKI among patients undergoing SAVR.
外科主动脉瓣置换术（SAVR）后急性肾损伤（AKI）的发生率会升高。本研究旨在明确SAVR后AKI的危险因素。
我们基于299例连续接受SAVR患者的数据进行了一项回顾性登记研究。SAVR术后48小时，41例患者发生了AKI。AKI组患者的年龄较大、体重指数（BMI）较高和糖尿病患病率显著更高。既往使用血管紧张素转换酶抑制剂/血管紧张素受体阻滞剂（ACEI/ARB）和β受体阻滞剂、24小时内的出入量、机械通气时间、重症监护病房和住院时间、基线肌酐、基线、24小时和48小时估算肾小球滤过率与AKI的发生率密切相关。BMI>24、高血压病史、使用ACEI/ARB和β受体阻滞剂以及机械通气时间与AKI相关。单因素逻辑回归表明超重、高血压、使用ACEI/ARB和β受体阻滞剂以及机械通气时间与AKI相关。值得注意的是，ACEF评分是AKI的独立预测因子。采用受试者工作特征曲线评估ACEF评分预测AKI的情况，最佳截断值为1.1。将ACEF分为四分位数后，ACEF每增加一个单位，患者发生AKI的风险增加2.27倍。
AKI是SAVR后常见的普遍现象。ACEF评分是接受SAVR患者发生AKI的独立预测因子。
