Original Article

Journal of Anesthesia

, Volume 25, Issue 6, pp 799-804

First online:

Acute kidney injury during aortic arch surgery under deep hypothermic circulatory arrest

  • Yosuke MoriAffiliated withThe First Department of Anesthesiology, Toho University, School of MedicineDepartment of Anesthesia, Kawasaki Saiwai Hospital
  • , Nobukazu SatoAffiliated withThe First Department of Anesthesiology, Toho University, School of Medicine
  • , Yoshiro KobayashiAffiliated withDepartment of Anesthesia, National Hospital Organization Tokyo Medical Center
  • , Ryoichi OchiaiAffiliated withThe First Department of Anesthesiology, Toho University, School of Medicine Email author 

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Abstract

Purpose

The aim of this investigation was to describe the renal outcome and to identify risk factors for acute kidney injury (AKI), as defined by the Acute Kidney Injury Network (AKIN), during aortic arch surgery (AAS) under deep hypothermic circulatory arrest (DHCA).

Methods

A retrospective and observational study has been performed. One hundred thirty-five patients requiring AAS under DHCA were studied.

Results

Seventy-one patients (52.6%) developed AKI during the postoperative period. A logistic regression analysis identified three independent risk factors for AKI: preoperative hypertension (HT), emergency surgery, and duration of DHCA. Renal replacement therapy (RRT) was required in four patients (3.0%). The postoperative mortality rate among the patients with AKI was 2.8%, which was not statistically different from the rate of 1.6% observed in the non-AKI group (P = 0.62).

Conclusions

A high incidence of AKI during AAS under DHCA was confirmed. Because AKI is highly associated with aortic surgery, novel approaches for protecting the kidneys other than deep hypothermia are needed. The logistic regression model identified HT, emergency surgery, and duration of DHCA as independent risk factors for AKI.

Keywords

Acute kidney injury Aortic arch surgery Deep hypothermic circulatory arrest Emergency surgery Hypertension