Body Mass Index is an Independent Predictor of Acute Kidney Injury after Aortic Total Arch Surgery for Type A Acute Aortic Dissection: A Retrospective Cohort Study

Abstract

Background: Thoracic aortic surgery and obesity are both associated with risk of acute kidney injury (AKI). We hypothesized that the risk of postoperative AKI increases when the body mass index (BMI) increases in patients undergoing aortic total arch surgery for Type A acute aortic dissection (AAD). Methods: We conducted a population-based cohort study in Beijing anzhen hospital from December 2015 to April 2017. All AAD patients receiving aortic total arch surgery were included. BMI was calculated on the basis of height and weight recorded on the day of hospital admission preoperatively. AKI was defined by the Kidney Disease Improving Global Outcomes criteria. Findings: We included 115 consecutive in this timeframe. The overall incidence of AKI was 53·0% (n=61). Mean age was 47·8±10·7 years; 25·2% were women. Mean BMI was 26·2±3·9kg/m2. In-hospital mortality was significantly higher in the AKI group (13·11% vs 1·85%; P=0·025). Multivariate logistic regression revealed that BMI was independently associated with the development of postoperative AKI after adjust other confounding factors (odds ratio [OR], 1·22; 95% confidence interval [CI], 1·07-1·39; P =0·004). Interpretation: Body mass index is independently associated with an increased risk of acute kidney injury after aortic total arch surgery. Further understanding of the molecular basis of this association is critical to the design of preventative strategies. Funding Statement: This study was supported by National Key R&D Program of China（2017YFC1308000）and the Beijing Lab for Cardiovascular Precision Medicine, Beijing, China. PXM2017_014226_000037. Declaration of Interests: The authors have declared that no conflicts of interest exist. Ethics Approval Statement: This study was approved by the human research and development committees of the Beijing Anzhen Hospital and was adhered to the rules of the Declaration of Helsinki and principles of Good Clinical Practice. Individual consent was waived for the retrospective study.