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Trends in Kidney Function and Chronic Kidney Disease after Surgery for Acute Type A Aortic Dissection
Abstract
Background We sought to assess the effect of postoperative renal failure (RF) on outcomes of acute type A aortic dissection (ATAAD) and identify predictors of chronic kidney disease (CKD) following ATAAD. Methods This retrospective single-center analysis included all adults with ATAAD from 2011 to 2023. Patients were stratified into RF and no RF groups. Logistic regression analyses were performed to identify predictors of CKD. A linear mixed effect regression model was created to identify the differences in glomerular filtration rate (GFR) change over time. Results A total of 515 patients comprising 39.6% women were included in this analysis. Estimated GFR at admission was lower in the RF group (59 vs. 65 mL/min/1.73 m 2, P = 0.04) while 30-day mortality was higher in the RF group (17.4% vs. 6.5%, P < 0.01). Rates of postoperative pneumonia (16.8% vs. 6.8%, P < 0.01), atrial fibrillation (61.1% vs. 30.8%, P < 0.01), and sepsis (6.3 vs. 1.5%, P < 0.01) were higher in the RF group. Creatinine at admission (odds ratio [OR]: 3.133, 95% confidence interval [CI] 1.539-6.379, P < 0.01) was associated with higher odds of developing CKD at 1 year. Creatinine at admission (OR: 2.512, 95% CI 1.035-6.096, P = 0.04), and atrial fibrillation (OR: 3.698, 95% CI 1.237-11.056, P = 0.02) were associated with higher odds of developing CKD at 5 years. Conclusions ATAAD-related postoperative RF is associated with significant morbidity and mortality; however, it is not predictive of CKD. Creatinine at admission was the most consistent predictor of CKD development at 1 and 5 years post-ATAAD.
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Metadata
- Authors
- Ahmad, D., Sá, M. P., Diaz Castrillon, C. E., Thoma, F., Wang, Y., Kaczorowski, D., Phillippi, J., West, D., Yoon, P., Bonatti, J., Chu, D., Serna-Gallegos, D., & Sultan, I.
- Affiliations
- University of Pittsburgh (US)
- University of Pittsburgh Medical Center (US)
- Corresponding author
- Sultan, Ibrahim
- ORCID
- Venue
- Annals of Vascular Surgery
- Publisher
- Elsevier BV
- Published
- 2025-03
- Volume
- 112
- Pages
- 139-147
- ISSN
- 0890-5096 (ISSN-L)
- OpenAlex
- W4405395429
- Cited by
- 3
- References
- 20
- Citations by year
- 2026: 2 · 2025: 1
- FWCI
- 0.87
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- Locations
- Annals of Vascular Surgery (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Aortic Disease and Treatment Approaches
- Health Sciences › Medicine › Nephrology › Acute Kidney Injury Research
- Health Sciences › Medicine › Surgery › Aortic aneurysm repair treatments
- Keywords
- acute type A aortic dissection, postoperative renal failure, chronic kidney disease, renal function, glomerular filtration rate, 30-day mortality, atrial fibrillation, postoperative complications
- MeSH terms
- Acute Disease, Aged, Aortic Dissection, Aortic Aneurysm, Female, Glomerular Filtration Rate, Humans, Kidney, Male, Middle Aged, Retrospective Studies, Risk Factors, Time Factors, Vascular Surgical Procedures, Treatment Outcome, Risk Assessment, Blood Vessel Prosthesis Implantation, Renal Insufficiency, Chronic
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