Outcomes of Patients with Postoperative Acute Kidney Injury After Acute Type A Aortic Dissection Repair.

Abstract

Introduction: Acute type A aortic dissection (ATAAD) repair is associated with high morbidity postoperatively. The aim of this study is to evaluate the incidence and risk factors for acute kidney injury in patients who underwent ATAAD repair. Patients and Methods: Two hundred and twenty-three patients underwent ATAAD repair. Postoperative acute kidney injury (AKI) was evaluated according to the Kidney Disease-Improving Global Outcomes (KDIGO) criteria. Results: Postoperative AKI was observed in 140 patients (62.8%). The patients with postoperative AKI classified by KDIGO stages: 1 = 53 (23.8%), 2 = 36 (16.1%), and 3 = 51 (22.9%) patients. Twenty-eight patients (12.6%) underwent replacement renal therapy due to severe renal impairment (KDIGO stage 3). Multivariable logistic regression analysis (adjusted to risk factors) showed that preoperative eGFR was the risk factor for postoperative RRT (odds ratio (OR) = 0.95, 95% CI: 0.92-0.97, p < 0.01). The lengths of hospital and intensive care-unit stay differed between the patients with and without postoperative RRT (p < 0.001 for both). Postoperative RRT was associated with 30-day mortality (10.3% versus 35.7%, p < 0.001). Conclusions: Postoperative AKI was associated with high morbidity and mortality rate in patients after ATAAD repair.