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Cited by 25Acute Kidney Injury ResearchAortic Disease and Treatment ApproachesChronic Kidney Disease and Diabetes

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Incidence and Transition of Acute Kidney Injury, Acute Kidney Disease to Chronic Kidney Disease after Acute Type A Aortic Dissection Surgery

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Chang, Chih-Hsiang, Chen, Shao-Wei, Chen, Jia-Jin, Chan, Yi-Hsin, Yen, Chieh-Li, Lee, Tao Han, Cheng, Yu-Ting·2021·Journal of Clinical Medicine
DOI 10.3390/jcm10204769PMC PMC8540632
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Abstract

Acute kidney disease (AKD) is the persistence of renal injury between days 8 and 90 after an initial acute kidney injury (AKI). In this study, we aimed to explore the incidence of AKD, the association between AKD, and patient outcomes after acute type A aortic dissection (type A AAD) surgery. We identified 696 participants who underwent type A AAD surgery. Patients were categorized into stages 1 to 3 or 0 (non-AKD) AKD groups. Outcomes included major adverse kidney events (MAKEs), respiratory failure, all-cause readmission, and ischemic stroke from day 91 after operation. A total of 376 (54%) participants developed AKI, and 135/376 (35.9%) developed AKD. Moreover, 34/320 (10.6%) patients without AKI still developed AKD. Overall, 169/696 (24.3%) participants developed AKD. Patients with stages 2 and 3 AKD are associated with persisted declined renal function within 1 year. AKD was associated with a higher risk of MAKEs (hazard ratio (HR): 2.52, 95% confidence interval (CI) 1.90–3.33) and all-cause readmission (HR: 2.86, 95% CI: 2.10–3.89). Development of AKD with or without AKI is associated with a higher risk of MAKEs and hospitalization after acute aortic dissection surgery. Higher-stage AKD is associated with a trend of persistent decline in kidney function.

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Figure 1 Diagram of patient selection. AKI, acute kidney injury; AKD, acute kidney disease.
Figure 1 Diagram of patient selection. AKI, acute kidney injury; AKD, acute kidney disease.CC BY · PubMed Central
Figure 2 Kidney function trajectory after acute kidney injury and acute kidney disease. (A) Trend of creatinine levels after operation according to AKI stage. AKI, acute kidney injury. Creatinine or eGFR data after dialysis initiation were not included in the figure. AKD, acute kidney disease; eGFR, estimated glomerular filtration rate. (B) Trend of eGFR after operation according to AKD stage. Creatinine or eGFR data after dialysis initiation were not included in the figure. AKD, acute kidney disease; eGFR, estimated glomerular filtration rate.
Figure 2 Kidney function trajectory after acute kidney injury and acute kidney disease. (A) Trend of creatinine levels after operation according to AKI stage. AKI, acute kidney injury. Creatinine or eGFR data after dialysis initiation were not included in the figure. AKD, acute kidney disease; eGFR, estimated glomerular filtration rate. (B) Trend of eGFR after operation according to AKD stage. Creatinine or eGFR data after dialysis initiation were not included in the figure. AKD, acute kidney disease; eGFR, estimated glomerular filtration rate.CC BY · PubMed Central
Figure 3 Directly adjusted one minus survival rates of MAKEs (A) and newly diagnosed CKD (B) after type A acute aortic dissection surgery in patients with or without AKD. MAKEs, major adverse kidney events; CKD, chronic kidney disease.
Figure 3 Directly adjusted one minus survival rates of MAKEs (A) and newly diagnosed CKD (B) after type A acute aortic dissection surgery in patients with or without AKD. MAKEs, major adverse kidney events; CKD, chronic kidney disease.CC BY · PubMed Central

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References 26 · Cited by 25

Research works printed but not linked: 26

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Metadata

Authors
Chang, C.-H., Chen, S.-W., Chen, J.-J., Chan, Y.-H., Yen, C.-L., Lee, T. H., & Cheng, Y.-T.
Affiliations
Chang Gung Memorial Hospital (TW)
Corresponding author
  • Chen, Shao-Wei
  • Chen, Jia-Jin
ORCID
Venue
Journal of Clinical Medicine
Publisher
MDPI AG
Published
2021-10-18
Volume
10
Issue
20
Pages
4769
ISSN
2077-0383 (ISSN-L)
DOI
10.3390/jcm10204769
PMC
PMC8540632
OpenAlex
W3205335460
Cited by
25
References
26
Citations by year
2026: 2 · 2025: 2 · 2024: 10 · 2023: 4 · 2022: 7
FWCI
3.59
Type
journal article
Language
en
Open access
Licence
Locations
  • Journal of Clinical Medicine (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, other-oa)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
  • Chang Gung Memorial Hospital (CMRPG5K0141)
  • Ministry of Science and Technology, Taiwan (109-2314-B-182A-124)
Topics
  • Health Sciences › Medicine › Nephrology › Acute Kidney Injury Research
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Aortic Disease and Treatment Approaches
  • Health Sciences › Medicine › Nephrology › Chronic Kidney Disease and Diabetes
Keywords
acute kidney injury, acute kidney disease, type A aortic dissection, aortic surgery, chronic kidney disease, major adverse kidney events, all-cause readmission, renal function decline, ischemic stroke, respiratory failure

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CoChat. (2026). Citation check: Incidence and Transition of Acute Kidney Injury, Acute Kidney Disease to Chronic Kidney Disease after Acute Type A Aortic Dissection Surgery. https://app.cochat.ai/papers/10.3390/jcm10204769
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Chang, C.-H., Chen, S.-W., Chen, J.-J., Chan, Y.-H., Yen, C.-L., Lee, T. H., & Cheng, Y.-T. (2021). Incidence and Transition of Acute Kidney Injury, Acute Kidney Disease to Chronic Kidney Disease after Acute Type A Aortic Dissection Surgery. Journal of Clinical Medicine. https://doi.org/10.3390/jcm10204769

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