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GAZZETTA MEDICA ITALIANA ARCHIVIO PER LE SCIENZE MEDICHE

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Gazzetta Medica Italiana Archivio per le Scienze Mediche 2013 July-August;172(7-8):553-60

Copyright © 2013 EDIZIONI MINERVA MEDICA

language: English

Clinical significance of acute kidney injury in non-surgical type-B acute aortic dissection

Hata N., Shinada T., Kobayashi N., Tomita K., Shirakabe A., Tsurumi M., Matsushita M., Shimura T.

Intensive Care Unit, Chiba Hokusoh Hospital Nippon Medical School, Inzai, Japan


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Aim: The aim of this study is to clarify the clinical significance of acute kidney injury (AKI), evaluated by standard method, in patients with non-surgical type-B acute aortic dissection (AAD).
Methods: AKI was evaluated by using the RIFLE (Risk, Injury, Failure, Loss of kidney function and End-stage kidney disease) classification in 94 non-surgical type-B AAD patients. The incidence of AKI during hospitalization, factors associated with the occurrence of AKI, and relationships between AKI and outcomes were analyzed retrospectively.
Result: AKI occurred in 59 (62.8%) during hospitalization on hospital day 4.6±5.4. The occurrence of AKI was associated with maximum C-reactive protein, white blood cell count, prolongation of high body temperature, and visceral ischemia including the kidney and the gastrointestinal tract. AKI frequently occurred in non-surgical type-B AAD patients, and it was associated with renal circulation and inflammatory reactions. The renal function recovered in 44% of AKI patients during hospitalization, especially in those without chronic renal insufficiency. The duration of both the stay in the ICU stay and hospital were longer in patients with severe AKI (class F category of AKI) than others.
Conclusion: AKI frequently occurred in non-surgical type-B AAD, and it was associated with renal circulation, inflammatory reactions, and poor outcome. And the renal function recovered in 44% of AKI patients during hospitalization, especially in those without chronic renal insufficiency.

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