scholarly journals Risk factors for acute kidney injury after Stanford type A aortic dissection repair: a systemetic review and meta-analysis

2021 ◽  
Author(s):  
Lei Wang ◽  
Guodong Zhong ◽  
Xiaochai Lv ◽  
Dong Yi ◽  
Yanting Hou ◽  
...  
Keyword(s):  
Risk Factors ◽  
Body Mass Index ◽  
Acute Kidney Injury ◽  
Cardiopulmonary Bypass ◽  
Aortic Dissection ◽  
Meta Analysis ◽  
Kidney Injury ◽  
High Body Mass Index ◽  
Type A Aortic Dissection ◽  
Postoperative Aki

Abstract Background Acute kidney injury (AKI) is one of the most common complications after Stanford type A aortic dissection (TAAD) repair surgery, but its risk factors are inconsistent in different studies. So this meta-analysis was conducted to systematically analyze the risk factors for AKI after TAAD repair surgery, so as to early identify the therapeutic targets for preventing AKI and to improve the outcomes. Methods Studies on risk factors for AKI after TAAD repair surgery were searched from PubMed, Embase, Cochrane library and Web of science from inception of databases to June 2021. The meta-analysis was performed by Stata 16.0 software. The combined incidence and risk factors of AKI and its impact on mortality after TAAD repair surgery were calculated. Results A total of 11 studies and 4156 patients were included. The combined incidence of postoperative AKI was 56.0%. The advanced age [odds ratio (OR)=1.32, 95% confidence interval (CI) (1.19, 1.47), P<0.001], cardiopulmonary bypass time > 180 minutes [OR=4.88, 95% CI (2.05, 11.59), P<0.001], red blood cell (RBC) volume transfused perioperatively [OR=1.13, 95% CI (1.03, 1.24), P<0.01], high body mass index [OR=1.22, 95% CI (1.18, 1.27), P<0.001] and preoperative renal malperfusion [OR= 5.32, 95% CI (2.92, 9.71), P<0.001] were risk factors for AKI after TAAD repair surgery. The in-hospital mortality [rate ratio (RR)=2.50, 95% CI (1.82, 3.44), P<0.001] and 30-day mortality [RR=2.81, 95% CI (1.95, 4.06), P<0.001] were higher in patients with postoperative AKI than that without AKI. Conclusions The incidence of AKI after TAAD repair surgery was high, and it increased the in-hospital and 30-day mortality. Reducing cardiopulmonary bypass time and RBC transfusions perioperatively, especially in elderly or patients with high body mass index, or patients with renal malperfusion preoperatively were important to prevent AKI after TAAD repair surgery.Systematic review registration number: INPLASY 202060100.

scholarly journals Risk factors for acute kidney injury after unilateral radical nephrectomy and inferior vena cava thrombectomy under cardiopulmonary bypass: a retrospective study

2021 ◽  
Author(s):  
Qi Zhang ◽  
Ming Li ◽  
Dongmei Fu ◽  
Dongxin Wang ◽  
Shiqi Diao
Keyword(s):  
Risk Factors ◽  
Acute Kidney Injury ◽  
Retrospective Study ◽  
Cardiopulmonary Bypass ◽  
Inferior Vena Cava ◽  
Radical Nephrectomy ◽  
Inferior Vena ◽  
Vena Cava ◽  
Kidney Injury ◽  
Postoperative Aki

Abstract In patients with renal cell carcinoma (RCC) and cancer-related thrombosis in the inferior vena cava (IVC) or right atrium (AT), it is still unknown whether nephrectomy, anesthesia, and surgical trauma can cause postoperative acute kidney injury (AKI) and what are the risk factors for AKI. To examine the incidence and risk factors of postoperative AKI in patients who underwent unilateral radical nephrectomy and cardiopulmonary bypass (CPB)-assisted thrombectomy in the IVC and/or atrial AT due to RCC complicated with cancer-associated thrombosis. This retrospective study included patients who underwent unilateral radical nephrectomy and CPB-assisted thrombectomy in the inferior vena cava and/or atrial pulmonary artery due to RCC, under general anesthesia, from December 2011 to June 2015, at Peking University First Hospital. Among 31 patients, 15 (48.4%) had postoperative AKI. Compared with the non-AKI group (n = 16), patients in the AKI group (n = 15) were older (59.0 ± 8.7 vs. 48.5 ± 12.9 years, P = 0.012) had smaller intraoperative urine volume (1225 ± 639 vs. 1685 ± 597 mL, P = 0.048). There were no differences in preoperative creatinine clearance. Age (OR = 1.10, 95%CI: 1.02–1.20, P = 0.020) was independently associated with AKI occurrence. The patients undergoing unilateral radical nephrectomy and CPB-assisted IVC thrombectomy have a high rate of AKI. Older ones are at a higher risk of postoperative AKI.

scholarly journals Perioperative Results and Risk Factors for In-Hospital Mortality In Patients With Stanford Type A Aortic Dissection Undergoing Sun’s Procedure - A Single Center Study

2018 ◽  
Vol 21 (6) ◽  
pp. E432-E437 ◽  
Author(s):  
YuHui Wu ◽  
Rui Jiang ◽  
Ping Xu ◽  
Guanron Wang ◽  
Jianhu Wang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Body Mass Index ◽  
Cardiopulmonary Bypass ◽  
Aortic Dissection ◽  
Hospital Mortality ◽  
Body Mass ◽  
Type A ◽  
The Body ◽  
Type A Aortic Dissection ◽  
Cardiopulmonary Bypass Time

Background: The study was to analyze the therapeutic effect and risk factors of in-hospital mortality in patients with acute Stanford type A aortic dissection operated by Sun’s procedure. Methods: From Jan. 2010 to March 2016, 72 patients whose data was fully accessible underwent Sun’s procedure in our hospital due to acute Stanford type A aortic dissection. Patients were divided into the survival group and the death group, and the risk factors for in-hospital mortality were collected and analyzed. Results: All 72 patients were diagnosed as acute Stanford type A aortic dissection by CT angiography in which the ascending aorta, aortic arch and descending aorta were involved; these patients were operated by Sun’s procedure. The operation of proximal aorta included 39 Bentall procedure, one David surgery, and 32 ascending aorta replacement. The in-hospital mortality rate was 19.4% (14 patients). Studies showed the risk factors for the in-hospital mortality included the body mass index, cardiopulmonary bypass time, operation time, intraoperative transfusion of red blood cells and plasma volume, and the total perioperative transfusion of red blood cells, plasma and cryoprecipitate volume. Independent risk factors included the body mass index and cardiopulmonary bypass time. Conclusion: Acute Stanford type A aortic dissection is a severe, complex disease with high in-hospital mortality, though the Sun’s procedure is an effective surgical approach in treating this kind of disease in some center. Body mass index and cardiopulmonary bypass time are independent risk factors for in-hospital mortality.

Global Risk Factors of Contrast-Induced Acute Kidney Injury: Systematic Review and Meta-Analysis

2020 ◽  
Author(s):  
Yong Liu ◽  
Shiqun Chen ◽  
Edmund Y. M. Chung ◽  
Li Lei ◽  
Yibo He ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Acute Kidney Injury ◽  
Meta Analysis ◽  
Kidney Injury ◽  
Global Risk

scholarly journals Assessment of Cardiopulmonary Bypass Duration Improves Novel Biomarker Detection for Predicting Postoperative Acute Kidney Injury after Cardiovascular Surgery

2021 ◽  
Vol 10 (13) ◽  
pp. 2741
Author(s):  
Tao Han Lee ◽  
Cheng-Chia Lee ◽  
Jia-Jin Chen ◽  
Pei-Chun Fan ◽  
Yi-Ran Tu ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Cardiopulmonary Bypass ◽  
Fatty Acid Binding Protein ◽  
Cardiovascular Surgery ◽  
Kidney Injury ◽  
Fatty Acid Binding ◽  
Discriminatory Ability ◽  
Postoperative Risk ◽  
Study Population ◽  
Postoperative Aki

Urinary liver-type fatty acid binding protein (L-FABP) is a novel biomarker with promising performance in detecting kidney injury. Previous studies reported that L-FABP showed moderate discrimination in patients that underwent cardiac surgery, and other studies revealed that longer duration of cardiopulmonary bypass (CPB) was associated with a higher risk of postoperative acute kidney injury (AKI). This study aims to examine assessing CPB duration first, then examining L-FABP can improve the discriminatory ability of L-FABP in postoperative AKI. A total of 144 patients who received cardiovascular surgery were enrolled. Urinary L-FABP levels were examined at 4 to 6 and 16 to 18 h postoperatively. In the whole study population, the AUROC of urinary L-FABP in predicting postoperative AKI within 7 days was 0.720 at 16 to 18 h postoperatively. By assessing patients according to CPB duration, the urinary L-FABP at 16 to 18 h showed more favorable discriminating ability with AUROC of 0.742. Urinary L-FABP exhibited good performance in discriminating the onset of AKI within 7 days after cardiovascular surgery. Assessing postoperative risk of AKI through CPB duration first and then using urinary L-FABP examination can provide more accurate and satisfactory performance in predicting postoperative AKI.

Acute kidney injury in children after cardiopulmonary bypass: Risk factors and outcome

2015 ◽  
Vol 52 (3) ◽  
pp. 223-226 ◽  
Author(s):  
Sidharth Kumar Sethi ◽  
Maneesh Kumar ◽  
Rajesh Sharma ◽  
Subeeta Bazaz ◽  
Vijay Kher
Keyword(s):  
Risk Factors ◽  
Acute Kidney Injury ◽  
Cardiopulmonary Bypass ◽  
Kidney Injury
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