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Novel and Innovative Hybrid Technique for Type A Aortic Dissection
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Risk Factors for Acute Kidney Injury After Surgery for Stanford Type A Aortic Dissection: A Systematic Review and

Fan Yang1, Hua Kang, Yiting Wang

  • 1From the School of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China.

Cardiology in Review
|May 19, 2026
PubMed
Summary

This study identified key risk factors for acute kidney injury (AKI) after Stanford type A aortic dissection surgery. Understanding these perioperative factors can help reduce AKI incidence and improve patient outcomes.

Keywords:
acute kidney injuryaortic dissectionrisk factorssystematic review/meta-analysis

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05:31

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Published on: May 16, 2025

Area of Science:

  • Cardiovascular Surgery
  • Nephrology
  • Critical Care Medicine

Background:

  • Stanford type A aortic dissection is a life-threatening condition requiring complex surgical intervention.
  • Acute kidney injury (AKI) is a common and serious complication following this surgery, impacting patient prognosis.
  • Identifying modifiable risk factors is crucial for improving surgical outcomes.

Purpose of the Study:

  • To systematically review and meta-analyze risk factors associated with AKI after Stanford type A aortic dissection surgery.
  • To provide a comprehensive overview of preoperative, intraoperative, and postoperative factors influencing AKI development.
  • To inform clinical practice for AKI prevention and management in this patient population.

Main Methods:

  • Systematic literature search across multiple databases (PubMed, Embase, Web of Science, etc.) from inception to January 2026.
  • Inclusion of 58 case-control studies, with quality assessment using the Newcastle-Ottawa Scale.
  • Meta-analysis to identify statistically significant risk and protective factors for AKI.

Main Results:

  • Preoperative risk factors include advanced age, hypertension, renal insufficiency, elevated cystatin C, lactate, creatinine, white blood cell count, and renal malperfusion. Higher left ventricular ejection fraction was protective.
  • Intraoperative factors increasing AKI risk: prolonged cardiopulmonary bypass, red blood cell transfusion, and total aortic arch replacement. Higher intraoperative urine output was protective.
  • Postoperative risk factors: prolonged mechanical ventilation and acute respiratory insufficiency.

Conclusions:

  • Multiple perioperative factors significantly impact the risk of AKI following Stanford type A aortic dissection repair.
  • Comprehensive assessment of identified risk factors can guide targeted management strategies.
  • Implementing these insights may reduce AKI incidence and enhance patient outcomes after aortic dissection surgery.