Risk factors of renal replacement therapy after Sun's procedure for acute Stanford A aortic dissection
10.3760/cma.j.issn.1001-4497.2019.08.004
- VernacularTitle:急性Stanford A型主动脉夹层孙氏手术后肾脏替代治疗的危险因素
- Author:
Yipeng GE
1
;
Chengnan LI
;
Yu XIA
;
Fucheng XIAO
;
Haiou HU
;
Tie ZHENG
;
Jun ZHENG
;
Yongmin LIU
;
Junming ZHU
;
Lizhong SUN
Author Information
1. 首都医科大学附属北京安贞医院心血管外科
- Keywords:
A-Aortic dissection;
Sun's procedure;
Renal replacement therapy
- From:
Chinese Journal of Thoracic and Cardiovascular Surgery
2019;35(8):462-465
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the risk factors of renal replacement therapy for acute Stanford A aortic dissection patients with acute renal injury (AKI) after Sun's operation.Methods From January 2016 to October 2017,144 patients with Stanford A aortic dissection who underwent Sun's procedure were enrolled in the study.Univariate analysis and logistic regression analysis were used to analyze the risk factors of continuous renal replacement therapy (CRRT).Variables with statistical difference from univariate analysis were included in multivariate logistic regression analysis.Results 8 patients (5.55％)died in hospital.16 patients (11.11％) needed CRRT for AKI.5 of them (31.25％) died in hospital.Of the 11 surviving patients,5 had complete recovery of renal function within 2 weeks after operation and stopped renal replacement therapy.The remaining 6 patients recovered their renal function within 3 months and stopped renal replacement therapy.Univariate analysis showed that there were significant differences in preoperative age,creatinine clearance,peripheral white blood cell count,D-dimer,myoglobin,double renal arteries in false lumen,aortic cross clamp time and red blood cell transfusions between the two groups.The above risk factors were included in multivariate logistic regression.The results showed that double renal arteries in false lumen (OR =24.64,P =0.002),serum creatinine clearance ＜ 85 ml/min (OR =4.99,P =0.02) and red blood cell transfusions (OR =1.17,P ＜ 0.001) were independent risk factors.Conclusion Double renal arteries in false lumen,serum creatinine clearance ＜ 85ml/min and red blood cell transfusions were independent risk factors for CRRT after Sun's procedure for acute Stanford A aortic dissection.For high-risk patients with double renal arteries in false lumen,and markedly decreased creatinine clearance before operation,red blood cell transfusions should be reduced as much as possible to reduce the risk of AKI after operation.
