The Incidence, Risk Factors and In-Hospital Mortality of Acute Kidney Injury in Patients After Surgery for Acute Type A Aortic Dissection: A Single-Center Retrospective Analysis of 335 Patients

Acute dissection of thoracic aorta carries a risk of renal ischemia followed by the development of a kidney failure. The optimal surgical and nonsurgical management of these patients, timing of intervention, and the factors predicting renal recovery are not well delineated and remain controversial. We present a case of acute type B thoracic aortic dissection with left kidney ischemia. Evaluation of renal function was performed by the means of internationally accepted Risk, Injury, Failure, Loss of kidney function, End stage kidney disease and Acute Kidney Injury Network classifications for acute kidney injury, renal duplex sonography, and intravascular ultrasound that demonstrated left renal artery dissection with a flap completely compressing the true lumen. The patient underwent thoracic endovascular aortic repair and left renal artery stent and recovered well. Six months later, at the follow-up visit, retrograde type A aortic dissection was found, which was successfully repaired. Reversal of renal ischemia after aortic dissection depends on the precise assessment of renal function and prompt intervention.

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GW26-e1250 Incidence, Risk Factors, and In-hospital Outcomes of Acute Kidney Injury Before Thoracic Endovascular Aneurysm Repair in Patients With Type B Acute Aortic Dissection

Journal of the American College of Cardiology ◽

10.1016/j.jacc.2015.06.859 ◽

2015 ◽

Vol 66 (16) ◽

pp. C223-C224

Author(s):

Xiao Wang ◽

Hongmei Ren ◽

Chunyan Hu ◽

Bin Que ◽

Hui Ai ◽

...

Keyword(s):

Risk Factors ◽

Acute Kidney Injury ◽

Aortic Dissection ◽

Acute Aortic Dissection ◽

Endovascular Aneurysm Repair ◽

Kidney Injury ◽

Type B ◽

Incidence Risk ◽

Thoracic Endovascular Aneurysm Repair ◽

Aneurysm Repair

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Incidence, risk factors, and adverse outcomes of acute kidney injury in very premature neonates: a single center experience

TURKISH JOURNAL OF MEDICAL SCIENCES ◽

10.3906/sag-2012-348 ◽

2021 ◽

Keyword(s):

Risk Factors ◽

Acute Kidney Injury ◽

Kidney Injury ◽

Adverse Outcomes ◽

Single Center ◽

Premature Neonates ◽

Single Center Experience ◽

Incidence Risk

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Analysis of Risk Factors for Acute Kidney Injury after Ascending Aortic Replacement Combined with Open Placement of Triple-Branched Stent Graft in Type A Aortic Dissection: A New Technique versus the Traditional Method in a Single Chinese Center

Medical Science Monitor ◽

10.12659/msm.892492 ◽

2015 ◽

Vol 21 ◽

pp. 674-680 ◽

Cited By ~ 5

Author(s):

Zhihuang Qiu ◽

Liangwan Chen ◽

Hua Cao ◽

Guican Zhang ◽

Fan Xu ◽

...

Keyword(s):

Risk Factors ◽

Acute Kidney Injury ◽

Aortic Dissection ◽

Stent Graft ◽

Traditional Method ◽

Kidney Injury ◽

Type A Aortic Dissection ◽

Aortic Replacement ◽

Ascending Aortic Replacement ◽

A New Technique

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Acute kidney injury in hospitalized patients with COVID-19

10.21203/rs.3.rs-39131/v1 ◽

2020 ◽

Cited By ~ 2

Author(s):

Joana Gameiro ◽

José Agapito Fonseca ◽

João Oliveira ◽

Filipe Marques ◽

João Bernardo ◽

...

Keyword(s):

Risk Factors ◽

Acute Kidney Injury ◽

Multivariate Analysis ◽

Kidney Disease ◽

Hospital Mortality ◽

Kidney Injury ◽

Hospitalized Patients ◽

Single Center ◽

Transient Aki ◽

Worse Prognosis

Abstract Introduction: The incidence of AKI in coronavirus disease 2019 (COVID-19) patients ranges from 0.5 to 35% and has been associated with worse prognosis. The purpose of this study was to evaluate the incidence, severity, duration, risk factors and prognosis of AKI in hospitalized patients with COVID-19.Methods: We conducted a retrospective single-center analysis of 192 hospitalized COVID-19 patients from March to May of 2020. AKI was diagnosed using the Kidney Disease Improving Global Outcome (KDIGO) classification based on serum creatinine (SCr) criteria. Persistent and Transient AKI were defined according to the Acute Disease Quality Initiative (ADQI) workgroup definitions.Results: In this cohort of COVID-19 patients, 55.2% developed AKI (n=106). The majority of AKI patients had persistent AKI (n=64, 60.4%). Overall, in-hospital mortality was 18.2% (n=35) and was higher in AKI patients (28.3% vs 5.9%, p<0.001, unadjusted OR 6.03 (2.22-16.37), p<0.001). On a multivariate analysis, older age (adjusted OR 1.08 (95% CI 1.02-1.13), p=0.004), lower Hb level (adjusted OR 0.69 (95% CI 0.53-0.91), p=0.007) and acidemia at presentation (adjusted OR 5.53 (95% CI 1.70-18.63), p=0.005), duration of AKI (adjusted OR 7.91 for persistent AKI (95% CI 2.39-26.21), p=0.001) and severity of AKI (adjusted OR 2.30 per increase in KDIGO stage (95% CI 1.10-4.82), p=0.027) were independent predictors of mortality.Conclusion: AKI was frequent in hospitalized patients with COVID-19. Persistent AKI and higher severity of AKI were independent predictors of in-hospital mortality.

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Characteristics and outcomes of Stanford type A aortic dissection patients with post-operation severe hyperbilirubinemia: a retrospective cohort study

10.21203/rs.3.rs-30855/v1 ◽

2020 ◽

Author(s):

Xiaolan Chen ◽

Ming Bai ◽

Lijuan Zhao ◽

Yangping Li ◽

Yan Yu ◽

...

Keyword(s):

Risk Factors ◽

Blood Transfusion ◽

Aortic Dissection ◽

Hospital Mortality ◽

Multivariate Logistic Regression Analysis ◽

Kidney Injury ◽

Type A ◽

Type A Aortic Dissection ◽

Post Operation ◽

Severe Hyperbilirubinemia

Abstract Background Hyperbilirubinemia is one of the common complications after cardiac surgery and is associated with increased mortality. However, to the best of our knowledge, the report on clinical significance of postoperative severe hyperbilirubinemia in Stanford type A aortic dissection (AAD) patients is limited. Methods Patients who underwent surgical treatment for AAD in our center between January 2015 and December 2018 were retrospectively screened. In-hospital mortality, long-term mortality, acute kidney injury (AKI), and the requirement of continuous renal replacement therapy (CRRT) were assessed as endpoints. Univariate and multivariate regression models were employed to identify the risk factors of these endpoints. Results 271 (12.3%) patients were included. Of the included patients, 222 (81.9%) experienced postoperative AKI, and 50 (18.5%) received CRRT. In-hospital mortality was 30.3%. The 1-year, 2-year, and 3-year cumulative mortality were 32.9%, 33.9%, and 35.3%, respectively. Multivariate Logistic regression analysis indicated that age (P < 0.033), AKI stage 3 (P < 0.001), the amount of blood transfusion after surgery (P = 0.019), mean arterial pressure (MAP) in the first postoperative day (P = 0.012), the use of extracorporeal membrane oxygenation (ECMO) (P = 0.02), and the peak total bilirubin (TB) concentration (P = 0.023) were independent risk factors of in-hospital mortality. The optimal cut-off value of peak TB on predicting in-hospital mortality was 121.2 µmol/l. Survival analysis showed significantly decreased survival for patients who developed severe, rather than mild, hyperbilirubinemia. Conclusions Post-operation severe hyperbilirubinemia is a common clinical presentation in AAD surgery patients. Post-operation severe hyperbilirubinemia AAD patients with older age, lower MAP, increased blood transfusion, stage 3 AKI, the use of ECMO, and the increased peak TB had higher risk of in-hospital mortality.

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