| Title: |
Acute kidney injury and aorta-related mortality during open surgery of the abdominal aorta with suprarenal clamping using different renal protection strategies |
| Authors: |
Piffaretti, Gabriele; Trimarchi, Santi; Bonardelli, Stefano; Tolva, Valerio; Civilini, Efrem; Nano, Giovanni; Pulli, Raffaele; Perini, Paolo; Lepidi, Sandro; Benedetto, Filippo; Verzini, Fabio; Veraldi, Gianfranco; Angiletta, Domenico; Bellosta, Raffaello; Franchin, Marco; Mauri, Francesca; Tozzi, Matteo; Lomazzi, Chiara; Grassi, Viviana; Fulgheri, Irene; D'alessio, Ilenia; Compagnoni, Nicola Monzio; Pascucci, Maria Giulia; Guglielmi, Edoardo; Pegorer, Matteo; Attisani, Luca; Mazzaccaro, Daniela; Righini, Paolo; Dorigo, Walter; Speziali, Sara; Freyrie, Antonio; Cabrini, Elisa; D'oria, Mario; D'andrea, Alessia; Barillà, Chiara; Giuffrè, Giuseppe; Gibello, Lorenzo; Ramirez, Mario Efraim Rios |
| Contributors: |
G. Piffaretti; S. Trimarchi; S. Bonardelli; V. Tolva; E. Civilini; G. Nano; R. Pulli; P. Perini; S. Lepidi; F. Benedetto; F. Verzini; G. Veraldi; D. Angiletta; R. Bellosta; M. Franchin; F. Mauri; M. Tozzi; C. Lomazzi; V. Grassi; I. Fulgheri; I. D'Alessio; N.M. Compagnoni; M.G. Pascucci; E. Guglielmi; M. Pegorer; L. Attisani; D. Mazzaccaro; P. Righini; W. Dorigo; S. Speziali; A. Freyrie; E. Cabrini; M. D'Oria; A. D'Andrea; C. Barillà; G. Giuffrè; L. Gibello; M.E.R. Ramirez |
| Publisher Information: |
Oxford University Press |
| Publication Year: |
2025 |
| Collection: |
The University of Milan: Archivio Istituzionale della Ricerca (AIR) |
| Subject Terms: |
Acute kidney injury; Custodiol®; Histidine-tryptophan-ketoglutarate; Juxtarenal aortic aneurysm; Open surgical repair; Pararenal aortic aneurysm; Suprarenal clamping; Settore MEDS-13/B - Chirurgia vascolare |
| Description: |
OBJECTIVES: The aim was to evaluate the incidence of acute kidney injury in patients treated with open surgical repair and suprarenal cross-clamp comparing no-perfusion strategy versus the renal perfusion with the histidine-tryptophan-ketoglutarate solution. METHODS: It is a physician-initiated, multicentre, retrospective observational study including patients treated with open surgical repair for abdominal aortic aneurysm between 1 January 2015 and 31 December 2021. Patients already on dialysis were excluded from the final analysis. A coarsened exact match identified 2 cohorts: no-perfusion strategy versus renal perfusion with the histidine-tryptophan-ketoglutarate solution. Primary outcomes were acute kidney injury incidence and survival at 30 day. Secondary outcomes were freedom from haemodialysis and survival at 1 year. RESULTS: We analysed 125 (28.7%) patients: 63 (14.5%) who did not receive renal perfusion and 62 (14.2%) who received the histidine-tryptophan-ketoglutarate perfusion. At 30 day, acute kidney injury rate (37.6%) was not different between the 2 groups [n = 24 (38.7%) vs 23 (36.5%); OR: 1.1, P = 0.855]. At 30 day, acute kidney injury development was associated with aneurysm extent (pararenal, OR: 2.28, 95% CI: 1.031-5.031, P = 0.042) and total time of intervention (threshold: 365 min, OR: 1.008, 95% CI: 1.003-1.012, P = 0.001). At 1 year, postoperative acute kidney injury did not impact mortality (OR: 3.4, P = 0.556), and freedom from haemodialysis was 100%. CONCLUSIONS: Postoperative acute kidney injury remains high at nearly 38%, but it did not impact on freedom from haemodialysis at 1 year as well as on overall survival. |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| Relation: |
info:eu-repo/semantics/altIdentifier/pmid/40341329; info:eu-repo/semantics/altIdentifier/wos/WOS:001496176700001; volume:67; issue:5; firstpage:1; lastpage:11; numberofpages:11; journal:EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY; https://hdl.handle.net/2434/1191078 |
| DOI: |
10.1093/ejcts/ezaf159 |
| Availability: |
https://hdl.handle.net/2434/1191078; https://doi.org/10.1093/ejcts/ezaf159 |
| Rights: |
info:eu-repo/semantics/openAccess ; license:Creative commons ; license uri:http://creativecommons.org/licenses/by-nc/4.0/ |
| Accession Number: |
edsbas.34609363 |
| Database: |
BASE |