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Can Renal Resistive Index Predict Acute Kidney Injury After Acute Type A Aortic Dissection Repair?

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机构: [1]Capital Med Univ, Beijing Anzhen Hosp, Dept Cardiovasc Surg, 2 Anzhen Rd, Beijing 100029, Peoples R China; [2]Capital Med Univ, Beijing Anzhen Hosp, Dept Ultrasound, Beijing, Peoples R China; [3]Inst Heart Lung & Blood Vessel Dis, Beijing, Peoples R China; [4]Beijing Engn Res Ctr Vasc Prostheses, Beijing, Peoples R China
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Background. This study sought to determine whether assessment of the renal resistive index (RRI) can predict the short-term reversibility of acute kidney injury (AKI) after repair of acute type A aortic dissection (TAAD).& para;& para;Methods. This prospective study included 62 patients undergoing repair of acute TAAD. Doppler-based RRIs were obtained preoperatively, immediately after the surgical procedure, and 6, 24, and 48 hours postoperatively. The occurrence of AKI was evaluated daily according to Acute Kidney Injury Network criteria. Persistent AKI was defined as AKI lasting longer than 3 days. The association between the maximum RRI level at different time points and persistent AKI was analyzed by the receiver-operating characteristic curve.& para;& para;Results. Of the 62 patients, 22 (35.5%) had no AKI, 21(33.9%) had transient AKI, and 19 (30.6%) had persistent AKI. The maximum RRI was 0.67 +/- 0.03 (0.62 to 0.71), 0.71 +/- 0.05 (0.59 to 0.79), and 0.78 +/- 0.05 (0.70 to 0.92) in the no AKI, transient AKI, and persistent AKI groups, respectively.The maximum level of RRI was significantly correlated with that of SCr during the first 48 hours postoperatively (rho = 0.606; p < 0.001). RRI could predict persistent AKI with an area under the receiver-operating characteristic curve of 0.918 (95% confidence interval, 0.850 to 0.986; p <0.001). A postoperative RRI of 0.725 or higher was a marker for early detection of persistent AKI with high sensitivity and specificity (94.7% and 72.1%, respectively).& para;& para;Conclusions. An elevated maximum RRI may be a predictor of persistent AKI after repair of acute TAAD.This is helpful for management decision making and improving the prognosis of patients with AKI. (C) 2017 by The Society of Thoracic Surgeons.

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出版当年[2016]版:
大类 | 2 区 医学
小类 | 2 区 外科 3 区 心脏和心血管系统 3 区 呼吸系统
最新[2023]版:
大类 | 2 区 医学
小类 | 2 区 呼吸系统 2 区 外科 3 区 心脏和心血管系统
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出版当年[2015]版:
Q1 SURGERY Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Q2 RESPIRATORY SYSTEM
最新[2023]版:
Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Q1 RESPIRATORY SYSTEM Q1 SURGERY

影响因子: 最新[2023版] 最新五年平均 出版当年[2015版] 出版当年五年平均 出版前一年[2014版] 出版后一年[2016版]

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第一作者机构: [1]Capital Med Univ, Beijing Anzhen Hosp, Dept Cardiovasc Surg, 2 Anzhen Rd, Beijing 100029, Peoples R China; [2]Capital Med Univ, Beijing Anzhen Hosp, Dept Ultrasound, Beijing, Peoples R China; [3]Inst Heart Lung & Blood Vessel Dis, Beijing, Peoples R China; [4]Beijing Engn Res Ctr Vasc Prostheses, Beijing, Peoples R China
通讯作者:
通讯机构: [1]Capital Med Univ, Beijing Anzhen Hosp, Dept Cardiovasc Surg, 2 Anzhen Rd, Beijing 100029, Peoples R China; [2]Capital Med Univ, Beijing Anzhen Hosp, Dept Ultrasound, Beijing, Peoples R China; [3]Inst Heart Lung & Blood Vessel Dis, Beijing, Peoples R China; [4]Beijing Engn Res Ctr Vasc Prostheses, Beijing, Peoples R China
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