Related Experiment Video

Updated: Apr 12, 2026

Novel and Innovative Hybrid Technique for Type A Aortic Dissection

Novel and Innovative Hybrid Technique for Type A Aortic Dissection

Published on: March 28, 2025

Chronic Kidney Disease Is Associated With a Higher Risk of Complications in Type a Aortic Dissection Repair: A

Renxi Li^1,2, Deyanira J Prastein³, Stephen J Huddleston²

¹The George Washington University School of Medicine and Health Sciences, Washington, DC, USA.

Vascular and Endovascular Surgery

|April 11, 2026

Insights

Chronic kidney disease (CKD) increases risks for major adverse cardiovascular events, myocardial infarction, and acute kidney injury after type A aortic dissection (TAAD) repair. Close monitoring of cardiac and renal complications is crucial for patients with moderate to severe CKD undergoing TAAD repair.

Area of Science:

Cardiovascular Surgery
Nephrology
Critical Care Medicine

Background:

Chronic kidney disease (CKD) is a known risk factor for mortality in patients with aortic diseases.
The specific impact of CKD on outcomes following type A aortic dissection (TAAD) repair requires further investigation.

Purpose of the Study:

To analyze the association between CKD and in-hospital outcomes after TAAD repair using a large, population-based dataset.
To identify specific complications and risk factors associated with CKD in TAAD repair patients.

Main Methods:

Utilized the National Inpatient Sample database (2015-2020) to identify patients undergoing TAAD repair.
Employed multivariable logistic regression to compare in-hospital outcomes between CKD and non-CKD groups, adjusting for covariates.
Conducted subgroup analyses based on CKD severity (mild, moderate, severe).

Main Results:

Patients with CKD (18.68%) had comparable in-hospital mortality but significantly higher risks of major adverse cardiovascular events, myocardial infarction, cardiogenic shock, mechanical ventilation, and acute kidney injury (AKI).
CKD patients exhibited a lower rate of pacemaker implantation.
Subgroup analysis revealed higher AKI rates in moderate CKD and increased cardiac complications in severe CKD patients compared to non-CKD patients.

Conclusions:

CKD is a significant risk factor for postoperative complications, particularly cardiac and renal issues, following TAAD repair.
Intensive monitoring and management of organ system complications are essential for patients with moderate to severe CKD undergoing TAAD repair.

Read full analysis

Abstract:

BackgroundWhile chronic kidney disease (CKD) has been identified as a risk factor for mortality in patients with aortic diseases, its impact on the outcomes of type A aortic dissection (TAAD) repair has not yet been thoroughly investigated. This study aimed to conduct a comprehensive, population-based analysis of the association of CKD with in-hospital outcomes following TAAD repair.MethodsPatients who underwent TAAD repair were identified in National Inpatient Sample from the last quarter of 2015-2020. Multivariable logistic regressions were used to compare in-hospital outcomes between patients with and without CKD while adjusting for demographics, comorbidities, hospital characteristics, primary payer status, and transfer-in status. Additional subgroup analyses compared mild, moderate, and severe CKD patients vs non-CKD patients.ResultsThere were 800 (18.68%) CKD patients and 3482 (81.32%) non-CKD patients who underwent TAAD repair. Patients with and without CKD had comparable in-hospital mortality (aOR = 0.883, 95 CI = 0.671-1.163, P = .38) and there was no difference in the transfer-in status or indication of delay from admission to operation. Patients with CKD had higher risks of major adverse cardiovascular event (MACE; aOR = 1.519, 95 CI = 1.115-2.069, P = .01), myocardial infarction (MI; aOR = 1.693, 95 CI = 1.135-2.524, P = .01), cardiogenic shock (aOR = 1.422, 95 CI = 1.136-1.779, P < 0.01), mechanical ventilation (aOR = 1.346, 95 CI = 1.109-1.634, P < .01), and acute kidney injury (AKI; aOR = 1.933, 95 CI = 1.596-2.343, P < .01). However, CKD patients had a lower rate of pacemaker implantation (aOR = 0.384, 95 CI = 0.167-0.882, P = .02). Subgroup analyses demonstrated that compared to those without CKD, mild-CKD patients had largely comparable outcomes, moderate-CKD patients had higher AKI, and severe-CKD patients had higher cardiac complications.ConclusionCKD is a significant risk factor for postoperative complications following TAAD repair. It is essential to closely monitor and manage organ system complications, particularly cardiac and renal complications, in patients with severe and moderate CKD undergoing TAAD repair.

Keywords:

aortic arch aortic dissection ascending chronic kidney disease renal

More Related Videos

A Large Animal Model for Acute Kidney Injury by Temporary Bilateral Renal Artery Occlusion

A Large Animal Model for Acute Kidney Injury by Temporary Bilateral Renal Artery Occlusion

Published on: February 2, 2021

Murine Model of Thoracic Aortic Dissection Induced by Oral β-Aminopropionitrile and Subcutaneous Angiotensin II Infusion

Murine Model of Thoracic Aortic Dissection Induced by Oral β-Aminopropionitrile and Subcutaneous Angiotensin II Infusion

Published on: May 16, 2025

Related Concept Videos

Aneurysm III: Interprofessional Care

Aneurysm III: Interprofessional Care

Aneurysm management involves either conservative medical therapy or surgical intervention, depending on the size and symptoms of the aneurysm. Conservative management is generally reserved for smaller, asymptomatic aneurysms, while larger or symptomatic aneurysms often necessitate surgical repair.Conservative Medical TherapyFor small, asymptomatic aneurysms, particularly abdominal aortic aneurysms (AAA) less than 5.5 centimeters in diameter, conservative medical therapy is recommended. This...

Acute Kidney Injury IV: Diagnostic Studies and Prevention

Acute Kidney Injury IV: Diagnostic Studies and Prevention

Accurate diagnosis and effective prevention are critical in managing Acute Kidney Injury (AKI), which is linked to high mortality rates ranging from 10% to 80%. Timely recognition of at-risk patients and careful monitoring can significantly reduce the likelihood of kidney damage.Diagnostic Assessments:The diagnostic process starts with a comprehensive medical history to identify prerenal, intrarenal, and postrenal causes.Prerenal causes, such as dehydration, hypotension, or blood loss, should...

Cardiac Catheterization I: Pre-Procedure Overview

Cardiac Catheterization I: Pre-Procedure Overview

Cardiac catheterization is an invasive diagnostic technique used to identify and evaluate structural and functional diseases of the heart and major blood vessels. This technique diagnoses congenital heart disease, coronary artery disease, valvular heart disease, and coronary spasms and assesses ventricular function. It helps guide treatment decisions, including the need for revascularization procedures like percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) and...

Chronic Kidney Disease I: Introduction

Chronic Kidney Disease I: Introduction

Chronic Kidney Disease (CKD) arises when the kidneys progressively lose their ability to function, ultimately leading to end-stage renal disease. At this advanced stage, the kidneys can no longer filter waste or maintain essential body functions, requiring renal replacement therapy (RRT) through dialysis or a kidney transplant for survival.Early-stage chronic kidney disease and detection challengesIn CKD's early stages, symptoms often remain absent because healthy nephrons compensate for...

Kidney Transplant I: Introduction

Kidney Transplant I: Introduction

A kidney transplant is a surgical approach that involves replacing a non-functioning kidney with a healthy one from a donor. This procedure is often a treatment option for end-stage renal disease (ESRD) patients. The method requires careful recipient selection, including evaluating various medical and psychosocial factors. These criteria vary between transplant centers but generally include assessments of the patient's overall health, adherence to medical recommendations, and lifestyle...

Aneurysm IV: Nursing Management

Aneurysm IV: Nursing Management

Vigilant monitoring for aneurysm rupture is essential for patients undergoing aortic surgery.Preoperative Nursing ManagementContinuously monitor the patient for manifestations of aneurysm rupture, such as pallor, weakness, tachycardia, hypotension, abdominal, back, groin, or periumbilical pain, changes in consciousness, and a pulsating abdominal mass. Regularly assess the patient's peripheral pulses.Instruct the patient to consume a clear liquid diet the day before surgery and administer...

Articles linked to this work by shared authors, journal, and citation graph.

Choosing the Right Approach: Laparoscopic Versus Open Surgery for Cecal Volvulus.

The American surgeon·2026

The changing landscape of temporary mechanical circulatory support devices in the new heart allocation system: A US nationwide analysis.

JTCVS open·2026

Building bridges: Extracorporeal membrane oxygenation versus mechanical ventilation as bridge to lung transplant-A nationwide analysis.

JTCVS open·2026

Thirty-day outcomes of spinal versus general anesthesia for high-risk patients undergoing open inguinal hernia repair.

Hernia : the journal of hernias and abdominal wall surgery·2026

Longer travel distances and ischemic times with ex vivo lung perfusion in the Composite Allocation Score era: A nationwide analysis.

The Journal of thoracic and cardiovascular surgery·2026

Impact of renal function on survival in idiopathic pulmonary fibrosis patients 65 years and older undergoing lung transplantation in the United States.

JTCVS open·2026

See all related articles