title: Acute kidney injury during aortic arch surgery under deep hypothermic circulatory arrest.
abstract: OBJECTIVE
  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.
authors.affiliation: The First Department of Anesthesiology, Toho University, School of Medicine, 6-11-1, Ohmori-Nishi, Ohta-ku, Tokyo, 143-8541, Japan.
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Mori
authors.forename: Nobukazu
authors.initials: N
authors.lastname: Sato
authors.forename: Yoshiro
authors.initials: Y
authors.lastname: Kobayashi
authors.forename: Ryoichi
authors.initials: R
authors.lastname: Ochiai
mesh_terms: D058186:Acute Kidney Injury / Q000209:etiology*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001013:Aorta, Thoracic / Q000601:surgery*; D050792:Circulatory Arrest, Deep Hypothermia Induced / Q000009:adverse effects* / Q000379:methods; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications; D015994:Incidence; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D017582:Renal Replacement Therapy / Q000379:methods; D012189:Retrospective Studies; D012307:Risk Factors; D014656:Vascular Surgical Procedures / Q000009:adverse effects*