Key result
Postoperative AKI requiring RRT after ATAAD repair is linked to ~247% higher 30-day mortality.
Why the study?
Acute type A aortic dissection repair is associated with high postoperative morbidity, prompting evaluation of the incidence and risk factors for acute kidney injury.
Cohort (n=223)
Absolute Event Rate: 35.7% vs 10.3%
p-value: p=<0.001
Postoperative acute kidney injury is highly prevalent (62.8%) following acute type A aortic dissection repair and is associated with increased length of stay and 30-day mortality.
AKI occurs in most ATAAD repair patients with RRT requirement associated with higher mortality; hypothesis-generating for renoprotection trials.
Introduction: 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. Patients and Methods: 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. Results: 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, p < 0.01). The lengths of hospital and intensive care-unit stay differed between the patients with and without postoperative RRT (p < 0.001 for both). Postoperative RRT was associated with 30-day mortality (10.3% versus 35.7%, p < 0.001). Conclusions: Postoperative AKI was associated with high morbidity and mortality rate in patients after ATAAD repair.
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Samanidis et al. (2024) conducted a cohort in Acute type A aortic dissection (ATAAD) (n=223). Postoperative renal replacement therapy (RRT) vs. No postoperative RRT was evaluated on 30-day mortality (p=<0.001). Postoperative acute kidney injury occurred in 62.8% of ATAAD repair patients, and requirement for renal replacement therapy was associated with increased 30-day mortality (35.7% vs 10.3%, p<0.001).
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