Inflammatory Markers for Predicting Post-operative Acute Kidney Injury in Patients with Acute Type A Aortic Dissection

Q: What are the key findings of this study?

Elevated pre-operative NLR, IL-6, and PLR independently predicted post-operative AKI in acute type A aortic dissection.

Q: What is the clinical evidence from this study?

Study design: Observational. Population: Acute Stanford type A aortic dissection (ATAAD) (n=135). Intervention: Pre-operative inflammatory markers (NLR, IL-6, and PLR) vs. Lower biomarker levels / Non-AKI group. Primary outcome: Post-operative acute kidney injury (AKI) within 7 days defined by 2012 KDIGO criteria (OR 1.28 for NLR (IL-6 OR 1.13; PLR OR 1.02), 95% CI 1.13-1.47, p=<0.01).

Q: What does this research mean for the field?

Elevated pre-operative interleukin-6, neutrophil-to-lymphocyte ratio, and platelet-to-lymphocyte ratio are independent risk factors that accurately predict post-operative acute kidney injury in patients with acute type A aortic dissection. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

Q: What question did this study set out to answer?

To explore the predictive value of pre-operative inflammatory markers for post-operative acute kidney injury in patients undergoing surgery for acute type A aortic dissection.

Xu Yu; Yongchun Nie; Yang Zhao; Qikui Wang; Zheng Li; Shibo Zhu; Liang Zhang

doi:10.21203/rs.3.rs-11306188/v1

November 10, 2026Open Access

Inflammatory Markers for Predicting Post-operative Acute Kidney Injury in Patients with Acute Type A Aortic Dissection

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Key result

Pre-operative NLR is linked to ~28% higher odds of post-operative AKI in acute aortic dissection.

OR 1.28 for NLR (IL-6 OR 1.13; PLR OR 1.02)
95% CI 1.13-1.47
P<0.01
n=135

Why the study?

Acute kidney injury is a common peri-operative complication of acute aortic dissection that increases in-hospital mortality and impairs long-term survival, prompting evaluation of the predictive value of inflammatory markers in acute type A aortic dissection.

Does pre-operative assessment of IL-6, NLR, and PLR predict post-operative acute kidney injury in patients with acute type A aortic dissection?

Key Points

To explore the predictive value of pre-operative inflammatory markers for post-operative acute kidney injury in patients undergoing surgery for acute type A aortic dissection.
Retrospective analysis of clinical data from 135 patients diagnosed with acute type A aortic dissection admitted to Anhui Provincial Chest Hospital from November 2022 to September 2025.
Patients were divided into AKI and non-AKI groups, and predictive performance of biomarkers was evaluated using multivariable logistic regression and receiver operating characteristic curves.
Post-operative acute kidney injury developed in 69 of the 135 enrolled patients (51.1%).
Multivariable logistic regression identified IL-6 (OR = 1.13, 95%CI: 1.01–1.04, P < 0.01), NLR (OR = 1.28, 95%CI: 1.13–1.47, P < 0.01), and PLR (OR = 1.02, 95%CI: 1.01–1.03, P = 0.013) as independent risk factors for AKI.
ROC curve analysis showed predictive accuracy for IL-6 (AUC = 0.842), NLR (AUC = 0.902), and PLR (AUC = 0.843), with a combined model yielding an AUC of 0.936 (95%CI: 0.896–0.976).

Study Design

Type

Observational (n=135)

Multicenter

No

Structured PICO

Does pre-operative assessment of IL-6, NLR, and PLR predict post-operative acute kidney injury in patients with acute type A aortic dissection?

P

Population

135 adult patients (mean age ~57.1 years, 28.9% female) undergoing surgery for acute type A aortic dissection without pre-existing chronic renal insufficiency, infection, or malignancy, followed for 7 days post-operatively.

E

Exposure

Pre-operative inflammatory markers assessment: interleukin-6 (IL-6), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR)

O

Outcome

Post-operative acute kidney injury (AKI) within one week after surgery, diagnosed according to the 2012 KDIGO criteria (serum creatinine increase ≥26.7 µmol/L within 48 hours, rise to ≥1.5 times baseline within 7 days, or urine output <0.5 mL/(kg·h) for >6 hours)hard clinical

Main Result

Odds Ratio: 1.28 (95% CI 1.13–1.47)

p-value: p=<0.01

Pre-operative inflammatory markers (IL-6, NLR, and PLR) are independently associated with and accurately predict the development of post-operative acute kidney injury in patients undergoing surgery for acute type A aortic dissection.

Limitations

Single-centre retrospective design with potential selection bias from excluding incomplete records
Relatively small sample size (n=135)
Lack of long-term follow-up regarding renal functional recovery
Single-centre retrospective investigation
Exclusion of patients with incomplete records may bring selection bias
Relatively small sample size and imbalanced group sizes may distort statistical results
Long-term follow-up regarding renal functional recovery was not performed

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Implication

May support preoperative risk stratification in acute type A aortic dissection; hypothesis-generating and requires prospective validation.

Abstract

Background Acute kidney injury (AKI) is one of the most common peri-operative complications of acute aortic dissection. It contributes to in-hospital mortality and exerts adverse impacts on patients’ long-term survival. Objective To explore the predictive value of inflammatory markers for post-operative acute kidney injury in patients with acute type A aortic dissection. Methods Clinical data of 135 patients diagnosed with acute type A aortic dissection admitted to Anhui Provincial Chest Hospital from November 2022 to September 2025 were retrospectively analyzed. Patients were divided into the AKI group and non-AKI group. Logistic regression and receiver operating characteristic (ROC) curves were applied to evaluate the predictive performance of inflammatory markers for AKI. Results Among the 135 enrolled patients, 69 (51.1%) developed post-operative AKI. Compared with the non-AKI group, the AKI group presented significantly higher interleukin-6 (IL-6), neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR). Logistic regression showed that IL-6 (OR = 1.13, 95%CI: 1.01–1.04, P < 0.01), NLR (OR = 1.28, 95%CI: 1.13–1.47, P < 0.01) and PLR (OR = 1.02, 95%CI: 1.01–1.03, P = 0.013) were independent risk factors for AKI in patients with acute type A aortic dissection. ROC curve analysis demonstrated that NLR, PLR and IL-6 possessed favourable predictive accuracy. Conclusion IL-6, NLR and PLR are correlated with AKI occurrence in patients with acute type A aortic dissection and have good reference value for predicting post-operative AKI.

Discussion

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Cite This Study

Yu et al. (2026) conducted an observational in Acute Stanford type A aortic dissection (ATAAD) (n=135). Pre-operative inflammatory markers (NLR, IL-6, and PLR) vs. Lower biomarker levels / Non-AKI group was evaluated on Post-operative acute kidney injury (AKI) within 7 days defined by 2012 KDIGO criteria (OR 1.28 for NLR (IL-6 OR 1.13; PLR OR 1.02), 95% CI 1.13-1.47, p=<0.01). Elevated pre-operative NLR, IL-6, and PLR independently predicted post-operative AKI in acute type A aortic dissection.

synapsesocial.com/papers/6af3382456c0fd1f7f33d913 https://doi.org/10.21203/rs.3.rs-11306188/v1

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Inflammatory Markers for Predicting Post-operative Acute Kidney Injury in Patients with Acute Type A Aortic Dissection

Key Points

Study Design

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

Inflammatory Markers for Predicting Post-operative Acute Kidney Injury in Patients with Acute Type A Aortic Dissection

Key Points

Study Design

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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