Samanidis George, Kolovou Kyriaki, Kanakis Meletios, Katsaridis Sotirios, Perreas Konstantinos
First Department of Adult Cardiac Surgery, Onassis Cardiac Surgery Center, 356 Leoforos Syggrou, 17674 Athens, Greece.
Department of Cardiac Surgery Intensive Care, Onassis Cardiac Surgery Center, 17674 Athens, Greece.
J Pers Med. 2024 Dec 28;15(1):9. doi: 10.3390/jpm15010009.
: Acute type A aortic dissection (ATAAD) repair is associated with high morbidity postoperatively. The aim of this study is to evaluate the incidence and risk factors for acute kidney injury in patients who underwent ATAAD repair. : Two hundred and twenty-three patients underwent ATAAD repair. Postoperative acute kidney injury (AKI) was evaluated according to the Kidney Disease-Improving Global Outcomes (KDIGO) criteria. Postoperative AKI was observed in 140 patients (62.8%). The patients with postoperative AKI classified by KDIGO stages: 1 = 53 (23.8%), 2 = 36 (16.1%), and 3 = 51 (22.9%) patients. Twenty-eight patients (12.6%) underwent replacement renal therapy due to severe renal impairment (KDIGO stage 3). Multivariable logistic regression analysis (adjusted to risk factors) showed that preoperative eGFR was the risk factor for postoperative RRT (odds ratio (OR) = 0.95, 95% CI: 0.92-0.97, < 0.01). The lengths of hospital and intensive care-unit stay differed between the patients with and without postoperative RRT ( < 0.001 for both). Postoperative RRT was associated with 30-day mortality (10.3% versus 35.7%, < 0.001). : Postoperative AKI was associated with high morbidity and mortality rate in patients after ATAAD repair.
急性A型主动脉夹层（ATAAD）修复术后并发症发生率较高。本研究旨在评估接受ATAAD修复术患者急性肾损伤的发生率及危险因素。223例患者接受了ATAAD修复术。根据改善全球肾脏病预后组织（KDIGO）标准评估术后急性肾损伤（AKI）情况。140例患者（62.8%）术后出现AKI。根据KDIGO分期，术后AKI患者情况如下：1期=53例（23.8%），2期=36例（16.1%），3期=51例（22.9%）。28例患者（12.6%）因严重肾功能损害（KDIGO 3期）接受了肾脏替代治疗。多变量逻辑回归分析（校正危险因素后）显示，术前估算肾小球滤过率（eGFR）是术后肾脏替代治疗的危险因素（比值比（OR）=0.95，95%可信区间：0.92 - 0.97，P<0.01）。术后接受肾脏替代治疗和未接受肾脏替代治疗的患者住院时间和重症监护病房停留时间存在差异（两者P均<0.001）。术后肾脏替代治疗与30天死亡率相关（分别为10.3%和35.7%，P<0.001）。ATAAD修复术后患者的术后AKI与高发病率和死亡率相关。
