| 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 G.; Trimarchi S.; Bonardelli S.; Tolva V.; Civilini E.; Nano G.; Pulli R.; Perini P.; Lepidi S.; Benedetto F.; Verzini F.; Veraldi G.; Angiletta D.; Bellosta R.; Franchin M.; Mauri F.; Tozzi M.; Lomazzi C.; Grassi V.; Fulgheri I.; D'alessio I.; Compagnoni N. M.; Pascucci M. G.; Guglielmi E.; Pegorer M.; Attisani L.; Mazzaccaro D.; Righini P.; Dorigo W.; Speziali S.; Freyrie A.; Cabrini E.; D'oria M.; D'andrea A.; Barillà C.; Giuffrè G.; Gibello L.; Ramirez M. E. R. |
| Contributors: |
Piffaretti G.; Trimarchi S.; Bonardelli S.; Tolva V.; Civilini E.; Nano G.; Pulli R.; Perini P.; Lepidi S.; Benedetto F.; Verzini F.; Veraldi G.; Angiletta D.; Bellosta R.; Franchin M.; Mauri F.; Tozzi M.; Lomazzi C.; Grassi V.; Fulgheri I.; D'Alessio I.; Compagnoni N. M.; Pascucci M. G.; Guglielmi E.; Pegorer M.; Attisani L.; Mazzaccaro D.; Righini P.; Dorigo W.; Speziali S.; Freyrie A.; Cabrini E.; D'Oria M.; D'Andrea A.; Barillà, C.; Giuffrè, G.; Gibello L.; Ramirez M. E. R. |
| Publication Year: |
2025 |
| Collection: |
Università degli Studi di Brescia: OPENBS - Open Archive UniBS |
| Subject Terms: |
Acute kidney injury; Custodiol®; Histidine-tryptophan-ketoglutarate; Juxtarenal aortic aneurysm; Open surgical repair; Pararenal aortic aneurysm; Suprarenal clamping |
| 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 |
| File Description: |
ELETTRONICO |
| 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/11379/635745 |
| DOI: |
10.1093/ejcts/ezaf159 |
| Availability: |
https://hdl.handle.net/11379/635745; https://doi.org/10.1093/ejcts/ezaf159 |
| Rights: |
info:eu-repo/semantics/openAccess ; license:Dominio pubblico ; license uri:http://creativecommons.org/publicdomain/zero/1.0/ |
| Accession Number: |
edsbas.D7AE4ED0 |
| Database: |
BASE |