ABSTRACT
Preoperative renal dysfunction is associated with mortality in patients who undergo coronary artery bypass graft and valve surgery. However, the role of preoperative renal dysfunction in type A aortic dissection (TAAD) remains unclear. This study aimed to evaluate the impact of preoperative renal dysfunction on the outcome of surgical intervention in patients with TAAD.We retrospectively studied the outcomes of 159 patients with TAAD who were treated at a tertiary referral hospital between 2005 and 2010. The demographics and surgical details of patients were analyzed according to their renal function. Risk factors for outcomes were analyzed using multivariable logistic regression. Thirty-two of the patients (20.1%) had preoperative serum creatinine of 1.5âmg/dL or more. The multivariable logistic regression model revealed independent risk factors of in-hospital mortality to be renal dysfunction (odds ratio [OR], 3.79; 95% confidence interval [CI], 1.64-8.77), preoperative shock (OR, 8.75; 95% CI, 2.83-27.02), and bypass time (OR, 1.008; 95% CI, 1.003-1.013). In addition, patients with renal dysfunction exhibited a lower 90-day survival rate than did patients without the condition (P of log-rank testâ=â.005).Preoperative renal dysfunction may have a critical role in the surgical outcomes of patients with TAAD. Additional large-scale investigations are warranted.
Subject(s)
Aortic Dissection/surgery , Kidney Diseases/diagnosis , Kidney Diseases/physiopathology , Kidney/physiopathology , Adult , Aged , Aortic Dissection/mortality , Aortic Dissection/physiopathology , Coronary Artery Bypass/mortality , Creatinine/blood , Female , Hospital Mortality , Humans , Kidney Diseases/mortality , Male , Middle Aged , Postoperative Complications/etiology , Preoperative Period , Prognosis , Retrospective Studies , Risk Factors , Survival Rate , Treatment OutcomeABSTRACT
BACKGROUND/PURPOSE: Indoxyl sulfate (IS) is a protein-binding molecule that exhibits cardiovascular (CV) toxicity. This study determined whether the serum IS level can be used to predict the risk of major adverse CV events (MACEs) in patients with chronic kidney disease (CKD). METHODS: We studied 147 patients with CKD stage 1-5 over a 3-year follow-up period. IS was measured through mass spectrometry. Patients' demographics were collected and analyzed to predict outcomes by using multivariable Cox regression. RESULTS: Forty-seven (32.0%) patients had MACEs. IS remained significantly associated with MACEs after multivariable regression analysis. The area under the receiver operating characteristic curve for IS levels was 0.708 (95% confidence interval: 0.618-0.798). CONCLUSION: IS may have a critical role in the prediction of CV disease in patients with CKD. Further large-scale investigations are warranted and suggested.
