Acute Kidney Injury in Patients with Acute Type B Aortic Dissection

Musajee, Mustafa; Katsogridakis, Emmanuel; Kiberu, Yusuf; Banerjee, Christopher; George, R; Modarai, Bijan; Saratzis, Athanasios; Sandford, Becky

doi:10.1016/j.ejvs.2022.10.032

Cited by 6 publications

(4 citation statements)

References 26 publications

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“…In this study, the prevalence of postoperative AKI in aortic dissection patients was found to be 20.29%, which is lower than in previous studies 22 , 23 , 24 and may be due to the lower mean age of the participants in this research. Meanwhile, the results of the present study confirm and extend previous findings.…”

Section: Discussioncontrasting

confidence: 81%

Variability of blood pressure and risk of postoperative acute kidney injury in patients undergoing surgery for acute aortic dissection: A 11‐year single‐center study

Zheng

Zhu

et al. 2023

J of Clinical Hypertension

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In patients receiving surgery, increased blood pressure variability may contribute to the onset of acute kidney injury (AKI). However, the extent and significance of blood pressure variability in patients undergoing aortic dissection surgery have yet to be determined. The authors analyzed all patients operated for aortic dissection at Peking University Shenzhen Hospital from January 1, 2011 to December 31, 2021. Preoperative blood pressure variability was expressed as standard deviation, coefficient of variation (CV), and range. The primary outcome was postoperative AKI. After multivariate analysis, systolic blood pressure variability was found to be independently associated with AKI after aortic dissection surgery. The odds ratios and 95% confidence intervals for standard deviation, CV, and systolic blood pressure range were 1.232 (1.011-1.500), 1.451 (1.058-1.991), and 1.138 (0.986-1.288) for postoperative AKI, respectively. However, there was no significant relationship between diastolic blood pressure variability and AKI after aortic dissection surgery. Finally, in patients undergoing surgery for aortic dissection, the variability of systolic blood pressure is actually an important factor in the development of AKI.

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Section: Discussioncontrasting

confidence: 81%

Variability of blood pressure and risk of postoperative acute kidney injury in patients undergoing surgery for acute aortic dissection: A 11‐year single‐center study

Zheng

Zhu

et al. 2023

J of Clinical Hypertension

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“…The literature reports a significant correlation between type B aortic dissection and acute kidney injury (AKI) but not much association with Stanford type A aortic dissection. Acute kidney injury is very common in patients with type B aortic dissection, even in clinically uncomplicated diseases [ 6 ]. For type A aortic dissections, AKI has been reported as a complication following surgical repair rather than an initial presenting feature [ 7 ], making this case all the more unique.…”

Section: Discussionmentioning

confidence: 99%

Extensive Aortic Dissection in a Low-Risk Male Causing Acute Kidney Injury: A Case Report

Anene

2023

Cureus

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Aortic dissection is a major differential diagnosis in an elderly male with severe chest pain radiating to the back who has a history of hypertension, smoking, or connective tissue disorders such as Marfan and Ehlers-Danlos syndromes. It is a medical emergency with a high mortality rate if undetected and untreated. This report describes the case of a patient presenting with extensive aortic dissection with no significant risk factors who was diagnosed following a CT angiogram of the aorta. He was subsequently managed medically before being transferred for definitive surgical management with a good outcome.

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“…Table 2 describes the observation periods for MAKE evaluation. Most articles (104 articles) evaluated MAKE at a single moment in time, while 18 articles [22,27,43,46,48,92,94,97,103,108,109,112,117,129,133,135,138,140] evaluated MAKE at multiple time points. Overall, thirteen different observation periods were employed across articles, with 30 days (27.9% in single period articles, 55.6% in multiple period articles) and 90 days (22.1% in single period articles, 77.8% in multiple period articles) as the most frequently used periods for evaluation.…”

Section: Observation Period For Make Evaluationmentioning

confidence: 99%

“…Additionally, we assessed another subset of articles from this scoping review cohort that reported MAKE rates for multiple observation periods (n = 13). [22,27,43,48,92,94,108,109,117,129,133,135,138] This analysis revealed that the median of the largest difference in reported MAKE rates resulting from different observation periods within each article was 7% [interquartile range (IQR): 1.7-16.7%] (supplementary Table S3).…”

Section: Observation Period For Make Evaluationmentioning

confidence: 99%

Heterogeneity in the definition of major adverse kidney events: a scoping review

Maeda,

Inokuchi,

Bellomo

et al. 2024

Intensive Care Med

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Acute kidney injury (AKI) is associated with persistent renal dysfunction, the receipt of dialysis, dialysis dependence, and mortality. Accordingly, the concept of major adverse kidney events (MAKE) has been adopted as an endpoint for assessing the impact of AKI. However, applied criteria or observation periods for operationalizing MAKE appear to vary across studies. To evaluate this heterogeneity for MAKE evaluation, we performed a systematic scoping review of studies that employed MAKE as an AKI endpoint. Four major academic databases were searched, and we identified 122 studies with increasing numbers over time. We found marked heterogeneity in applied criteria and observation periods for MAKE across these studies, with some even lacking a description of criteria. Moreover, 13 different observation periods were employed, with 30 days and 90 days as the most common. Persistent renal dysfunction was evaluated by estimated glomerular filtration rate (34%) or serum creatinine concentration (48%); however, 37 different definitions for this component were employed in terms of parameters, cut-off criteria, and assessment periods. The definition for the dialysis component also showed significant heterogeneity regarding assessment periods and duration of dialysis requirement (chronic vs temporary). Finally, MAKE rates could vary by 7% [interquartile range: 1.7-16.7%] with different observation periods or by 36.4% with different dialysis component definitions. Our findings revealed marked heterogeneity in MAKE definitions, particularly regarding component assessment and observation periods. Dedicated discussion is needed to establish uniform and acceptable standards to operationalize MAKE in terms of selection and applied criteria of components, observation period, and reporting criteria for future trials on AKI and related conditions.

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Acute Kidney Injury in Patients with Acute Type B Aortic Dissection

Cited by 6 publications

References 26 publications

Variability of blood pressure and risk of postoperative acute kidney injury in patients undergoing surgery for acute aortic dissection: A 11‐year single‐center study

Variability of blood pressure and risk of postoperative acute kidney injury in patients undergoing surgery for acute aortic dissection: A 11‐year single‐center study

Extensive Aortic Dissection in a Low-Risk Male Causing Acute Kidney Injury: A Case Report

Heterogeneity in the definition of major adverse kidney events: a scoping review

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