Predictors of Acute Kidney Injury Following Aortic Arch Surgery

Ghincea, Christian V.; Reece, T. Brett; Eldeiry, Mohamed; Roda, Gavriel F.; Bronsert, Michael; Jarrett, Michael; Pal, Jay D.; Cleveland, Joseph C.; Fullerton, David A.; Aftab, Muhammad

doi:10.1016/j.jss.2019.03.055

Cited by 27 publications

(19 citation statements)

References 32 publications

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“…The patients included in this study underwent open surgery of aorta and vena cava, which may be extremely difficult due to the complicated anatomic structures and abundant collateral circulations [9,16]. These procedures are usually accompanied with prolonged length of surgery, higher bleeding risk, and more complicated perioperative course, placing the patients at increased risk of AKI [3,8,17]. In our study, the surgical duration of postoperative AKI groups was longer than that of no-AKI groups.…”

Section: Plos Onementioning

confidence: 66%

“…Despite the development of endovascular procedures, open surgeries of aorta and vena cava are still used, especially in patients who are not suitable for endovascular procedures, and are associated with substantial mortality and complicated courses [ 1 – 3 ]. AKI in a common complication associated with open surgeries of aorta and vena cava.…”

Section: Discussionmentioning

confidence: 99%

“…the observation from different patients [3,15]. In our study, we assessed the incidence and risk factors of AKI in patients underwent open surgery of aorta and vena cava.…”

Section: Plos Onementioning

confidence: 99%

“…Acute kidney injury (AKI) is a prevalent and prognostically significant complication in surgical patients. Depending on the AKI definitions adopted and the population studied, AKI occurs in up to 16% -48% of surgical patients [1][2][3]. AKI after any type of surgery is independently associated with substantially worse outcomes, including higher short-term mortality, prolonged length of hospital stay, worsened long-term survival, and increased risk of end stage renal disease (ESRD) [4][5][6][7][8].…”

Section: Introductionmentioning

confidence: 99%

“…These procedures are usually associated with significant blood loss, which may result in hypovolemia or hypoxemia. Regionally reduced oxygen supply lead to physiologically low oxygen tensions within the renal cortex and the medulla and may cause postoperative AKI [2,3]. However, most previous researches focused on AKI after endovascular procedures which may be associated with contrast use, and the prevalence, risk factors and outcomes of AKI after open aorta and vena cava surgeries were poorly addressed in the literatures.…”

Section: Introductionmentioning

confidence: 99%

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Postoperative anemia is a risk factor for acute kidney injury after open aorta and vena cava surgeries

Cui

Shao

et al. 2020

PLoS ONE

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Open aorta and vena cava surgeries are usually associated with substantial blood loss which may result in postoperative acute kidney injury (AKI). The present study is designed to investigate the prevalence, outcome and risk factors of postoperative AKI associated with open aorta and vena cava surgeries, with a focus on the role of anemia in these conditions. A retrospective review of medical records of Peking Union Medical College Hospital was conducted. Patients who underwent open aorta and vena cava surgeries during January 1, 2010 and June 30, 2014 were included in this study. The primary analysis was between patients underwent open aorta and vena cava surgeryies, with or without postoperative AKI. Multivariable logistic regression models were used to determine risk factors of postoperative AKI. The study included 79 patients (63.3% male) with a mean age of 52.5±17.3 years (range, 17-81 years). Postoperative AKI occurred in 23/79 (29.1%) of the patients. Anemia was present in 11/79 (16%) at baseline, and increased to 45/79 (52%) postoperatively. After adjustment for various risk factors, postoperative anemia (OR, 5.202; 95% CI 1.403-19.285) was independently associated with postoperative AKI. AKI is a common complication in patients who undergo open aorta and vena cava surgeries, and postoperative anemia was the most relevant predictive factor of AKI. Strategies to minimize bleeding and anemia for all patients may be advisable. Further studies are needed to assess the impact of AKI on long term outcome and to examine preventive strategies to address potentially modifiable risk factors.

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Section: Plos Onementioning

confidence: 66%

Section: Discussionmentioning

confidence: 99%

“…the observation from different patients [3,15]. In our study, we assessed the incidence and risk factors of AKI in patients underwent open surgery of aorta and vena cava.…”

Section: Plos Onementioning

confidence: 99%