Incidence and outcomes of acute kidney disease in patients after type A aortic dissection surgery
Background: Acute kidney injury (AKI), acute kidney disease (AKD) and CKD (chronic kidney disease) were a continuous process. There has been little discussion of risk factors for AKD in the population undergoing surgery for acute type A aortic dissection (AAAD). Objective: The main objective of this...
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| Format: | Article |
| Language: | English |
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Elsevier
2023-03-01
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| Series: | Asian Journal of Surgery |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1015958422011149 |
| _version_ | 1811160854570205184 |
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| author | Xuelian Chen Miao Fang Jia Yang Siwen Wang Xin Wang Linji Li Jiaojiao Zhou Lichuan Yang |
| author_facet | Xuelian Chen Miao Fang Jia Yang Siwen Wang Xin Wang Linji Li Jiaojiao Zhou Lichuan Yang |
| author_sort | Xuelian Chen |
| collection | DOAJ |
| description | Background: Acute kidney injury (AKI), acute kidney disease (AKD) and CKD (chronic kidney disease) were a continuous process. There has been little discussion of risk factors for AKD in the population undergoing surgery for acute type A aortic dissection (AAAD). Objective: The main objective of this study was to investigate the risk factors for AKD after surgery for acute type A aortic dissection and the impact of AKD on early and late mortality. Design: AKI was to be defined as an increase in serum creatinine to >0.3 mg/dL or 1.5 times above baseline within 7 days. AKD was defined as the kidney damage within 90 days after AKI. Logistic regression models were performed to identify the risk factors of AKD and the association between AKD and early mortality after AAAD surgery. Participants: Patients with AKI after AAAD surgery admitted in ICU from March 2009 to September 2021 were included. Key results: Among the 328 patients who developed AKI after AAAD surgery, 98 patients (29.9%) progressed to AKD. Multivariable analysis revealed that AKI stage 2 (OR, 3.032) and AKI stage 3 (OR, 4.001) have been shown to be independent risk factors for the development of AKD. AKD (OR, 3.175) proved to be an independent risk factor for early mortality, while no significant difference in late mortality was observed between patients in the AKD and non-AKD groups. Conclusion: The severity of AKI after surgery of AAAD was independently associated with AKD. The occurrence of AKD had a negative impact on early mortality. Clinical trial registration: ChiCTR, ChiCTR1900021290. Registered 12 February 2019, http://www.chictr.org.cn/showproj.aspx?proj=35795. |
| first_indexed | 2024-04-10T06:05:16Z |
| format | Article |
| id | doaj.art-1cdf86cd63a34693867d5f9c34b1eb78 |
| institution | Directory Open Access Journal |
| issn | 1015-9584 |
| language | English |
| last_indexed | 2024-04-10T06:05:16Z |
| publishDate | 2023-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Asian Journal of Surgery |
| spelling | doaj.art-1cdf86cd63a34693867d5f9c34b1eb782023-03-03T04:23:31ZengElsevierAsian Journal of Surgery1015-95842023-03-0146312071214Incidence and outcomes of acute kidney disease in patients after type A aortic dissection surgeryXuelian Chen0Miao Fang1Jia Yang2Siwen Wang3Xin Wang4Linji Li5Jiaojiao Zhou6Lichuan Yang7Division of Nephrology, Department of Medicine, West China Hospital of Sichuan University, Chengdu 610041, Sichuan, ChinaDepartment of Orthopedics, Second People's Hospital of Chengdu. Chengdu, ChinaDivision of Nephrology, Department of Medicine, West China Hospital of Sichuan University, Chengdu 610041, Sichuan, ChinaDivision of Nephrology, Department of Medicine, West China Hospital of Sichuan University, Chengdu 610041, Sichuan, ChinaDepartment of Pediatric Nephrology, West China Second University Hospital, Sichuan University, Chengdu 610041, ChinaDepartment of Anesthesiology, Nanchong Central Hospital, The Second Clinical Medical College, North Sichuan Medical College, Nanchong, ChinaDepartment of Ultrasound, West China Hospital, Sichuan University, Chengdu, China; Corresponding author. Jiaojiao Zhou, Department of Ultrasound, West China Hospital of Sichuan University, #37 Guoxue Alley, Chengdu 610041, Sichuan, China.Division of Nephrology, Department of Medicine, West China Hospital of Sichuan University, Chengdu 610041, Sichuan, China; Corresponding author. Lichuan Yang: Division of Nephrology, West China Hospital of Sichuan University, #37 Guoxue Alley, Chengdu 610041, Sichuan, China.Background: Acute kidney injury (AKI), acute kidney disease (AKD) and CKD (chronic kidney disease) were a continuous process. There has been little discussion of risk factors for AKD in the population undergoing surgery for acute type A aortic dissection (AAAD). Objective: The main objective of this study was to investigate the risk factors for AKD after surgery for acute type A aortic dissection and the impact of AKD on early and late mortality. Design: AKI was to be defined as an increase in serum creatinine to >0.3 mg/dL or 1.5 times above baseline within 7 days. AKD was defined as the kidney damage within 90 days after AKI. Logistic regression models were performed to identify the risk factors of AKD and the association between AKD and early mortality after AAAD surgery. Participants: Patients with AKI after AAAD surgery admitted in ICU from March 2009 to September 2021 were included. Key results: Among the 328 patients who developed AKI after AAAD surgery, 98 patients (29.9%) progressed to AKD. Multivariable analysis revealed that AKI stage 2 (OR, 3.032) and AKI stage 3 (OR, 4.001) have been shown to be independent risk factors for the development of AKD. AKD (OR, 3.175) proved to be an independent risk factor for early mortality, while no significant difference in late mortality was observed between patients in the AKD and non-AKD groups. Conclusion: The severity of AKI after surgery of AAAD was independently associated with AKD. The occurrence of AKD had a negative impact on early mortality. Clinical trial registration: ChiCTR, ChiCTR1900021290. Registered 12 February 2019, http://www.chictr.org.cn/showproj.aspx?proj=35795.http://www.sciencedirect.com/science/article/pii/S1015958422011149Acute kidney diseaseAcute kidney injuryacute type A aortic dissectionRisk factorsOutcomes |
| spellingShingle | Xuelian Chen Miao Fang Jia Yang Siwen Wang Xin Wang Linji Li Jiaojiao Zhou Lichuan Yang Incidence and outcomes of acute kidney disease in patients after type A aortic dissection surgery Asian Journal of Surgery Acute kidney disease Acute kidney injury acute type A aortic dissection Risk factors Outcomes |
| title | Incidence and outcomes of acute kidney disease in patients after type A aortic dissection surgery |
| title_full | Incidence and outcomes of acute kidney disease in patients after type A aortic dissection surgery |
| title_fullStr | Incidence and outcomes of acute kidney disease in patients after type A aortic dissection surgery |
| title_full_unstemmed | Incidence and outcomes of acute kidney disease in patients after type A aortic dissection surgery |
| title_short | Incidence and outcomes of acute kidney disease in patients after type A aortic dissection surgery |
| title_sort | incidence and outcomes of acute kidney disease in patients after type a aortic dissection surgery |
| topic | Acute kidney disease Acute kidney injury acute type A aortic dissection Risk factors Outcomes |
| url | http://www.sciencedirect.com/science/article/pii/S1015958422011149 |
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