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Open Access 01-12-2022 | Acute Kidney Injury | Research

Identification of risk factors for postoperative stage 3 acute kidney injury in patients who received surgical repair for acute type A aortic dissection

Authors: Zhigang Wang, Min Ge, Zheyun Wang, Cheng Chen, Lichong Lu, Lifang Zhang, Dongjin Wang

Published in: BMC Surgery | Issue 1/2022

Abstract

Background

Acute kidney injury (AKI) is a serious complication that often occurred after acute type A aortic dissection (ATAAD) surgery. Previous studies proved that the Kidney Disease Improving Global Outcomes (KDIGO) defined stage 3 AKI was associated with lower long-term survival rate. However, the risk factors for developing stage 3 AKI had not been identified. The aim of the study was to explore the risk factors for developing KDIGO stage 3 after ATAAD operation.

Methods

This study included 993 patients who received ATAAD operation from 2014 to 2019 at the Nanjing Drum Tower Hospital. Postoperative AKI was diagnosed according to the KDIGO criteria. Multivariate logistic regression analyses were applied to identify risk factors for stage 3 AKI. Kaplan–Meier survival analyses and Cox proportional hazards regression model were conducted to explore the association between different AKI stages and postoperative survival rate.

Results

The mean age of all enrolled patients was 53.0 ± 13.1 years. A total of 236 (23.8%) patients suffered postoperative stage 3 AKI including 165 patients who required renal replacement therapy. Advanced age (odds ratio [OR] 1.031; 95% confidence interval [CI] 1.005–1.057; P = 0.018), prolonged cardiopulmonary bypass (CPB) duration (OR 1.010; 95% CI 1.002–1.018; P = 0.013), and higher drainage volume 24 h after surgery (OR 1.000; 95% CI 1.000–1.001; P = 0.033) were identified as independent risk factors for developing stage 3 AKI. In addition, our result showed that the mortality rate was correlated significantly with the severity of AKI defined by KDIGO criteria and the Cox regression analysis showed that only stage 3 AKI, but not stage 1 and 2, was an independent risk factor for mortality (Hazard ratio 10.365, 95% CI 4.208 to 25.528; P < 0.001) after adjusting for important confounding factors.

Conclusions

Our study suggested that stage 3 postoperative AKI was significantly associated with decreased postoperative survival rate after ATAAD surgery. Advanced age, increased CPB duration and drainage volume 24 h after surgery were identified as risk factors for developing stage 3 AKI.

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Title: Identification of risk factors for postoperative stage 3 acute kidney injury in patients who received surgical repair for acute type A aortic dissection
Authors: Zhigang Wang
Min Ge
Zheyun Wang
Cheng Chen
Lichong Lu
Lifang Zhang
Dongjin Wang
Publication date: 01-12-2022
Publisher: BioMed Central
Keywords: Acute Kidney Injury
Acute Kidney Injury
Aortic Dissection
Published in: BMC Surgery / Issue 1/2022
Electronic ISSN: 1471-2482
DOI: https://doi.org/10.1186/s12893-022-01526-x

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Identification of risk factors for postoperative stage 3 acute kidney injury in patients who received surgical repair for acute type A aortic dissection

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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