Outcomes and risk management in type B aortic dissection patients with acute kidney injury: a concise review

Figures & data

Table 1. AKI as defined by RIFLE, AKIN, and KDIGO.

RIFLE			AKIN			KDIGO
Stage	SCr	Urine output	Stage	SCr	Urine output	Stage	SCr	Urine output
Risk	SCr increase to 1.5-fold OR GFR decrease > 25% from baseline	<0.5 mL/kg/h for 6 h	1	SCr increase ≥ 26.5 μmol/L (≥ 0.3 mg/dL) OR increase of 1.5-fold to 2.0-fold from baseline	<0.5 mL/kg/h for 6 h	1	Increase in SCr 1.5× to 1.9× baseline OR ≥ 0.3 mg/dL (≥ 26.5 μmol/L) increase	<0.5 mL/kg/h for 6–12 h
Injury	SCr increase to 2.0-fold OR GFR decrease > 50% from baseline	<0.5 mL/kg/h for 12 h	2	SCr increase > 2.0- to 3.0-fold from baseline	<0.5 mL/kg/h for 12 h	2	Increase in SCr 2.0× to 2.9× baseline	<0.5 mL/kg/h ≥ 12 h
Failure	SCr increase to 3.0-fold OR GFR decrease > 75% from baseline OR SCr ≥ 354 μmol/L (≥ 4 mg/dL) with an acute increase of ≥ 44 μmol/L (0.5 mg/dL)	<3 mL/kg/h for 24 h OR Anuria for 12 h	3	SCr increase >3.0-fold from baseline OR SCr ≥ 354 μmol/L (≥ 4.0 mg/dL) with an acute increase of ≥ 44 μmol/L (0.5 mg/dL) OR need for CRRT	<0.3 mL/kg/h for 24 h OR anuria for 12 h	3	Increase in SCr to 3.0× baseline OR increase in SCr to ≥ 4.0 mg/dL OR initiation of CRRT OR in patients < 18 years, decrease in eGFR to < 35 mL/min per 1.73 m	<0.3 mL/kg/h ≥ 24 h OR Anuria ≥ 12 h

CRRT: continuous renal replacement therapy; GFR: glomerular filtration rate; SCr: creatinine

Figure 1. Potential mechanisms of AKI in type B aortic dissection patients.

Table 2. Risk factors of AKI for patients with type B aortic dissection.

Patient-related factors

Chronic kidney disease

Congestive heart failure

Hypertension

Limb malperfusion

Renal malperfusion

Renal artery involvement (bilateral)

Visceral malperfusion

Systolic blood pressure on admission

Electrocardiographic ST-T changes

Serum creatinine on admission (per 0.1 mg/dL)

Blood glucose on admission (per 10 mg/dL)

The relative area change of true lumen

Procedure-related factors

Preoperative factors

Malperfusion complications

Diabetes mellitus

The relative area change of true lumen

Systolic blood pressure on admission > 140 mmHg

Preoperative Hb (1 g/dL increase)

Intraoperative factors

Contrast medium (100 mL increase)

Supra-aortic branches graft bypass hybrid surgery

Postoperative factors

Hemoglobin reduction (1 g/dL increase)

Data availability statement

The data that support the findings of this study are available on request from the corresponding author.