Abstract
Acute kidney injury (AKI) is one of the most common post-operative complications and is closely associated with increased mortality after open and endovascular thoracoabdominal aortic aneurysm (TAAA) repair. Ribonuclease (RNase) 1 belongs to the group of antimicrobial peptides elevated in septic patients and indicates the prediction of two or more organ failures. The role of RNase 1 and its antagonist RNase inhibitor 1 (RNH1) after TAAA repair is unknown. In this study, we analyzed RNase 1 and RNH1 serum levels in patients undergoing open (n = 14) or endovascular (n = 19) TAAA repair to determine their association with post-operative AKI and in-hospital mortality. Increased RNH1 serum levels after open TAAA repair as compared with endovascular TAAA repair immediately after surgery and 12, 48, and 72 h after surgery (all p < 0.05) were observed. Additionally, elevated RNase 1 and RNH1 serum levels 12, 24, and 48 h after surgery were shown to be significantly associated with AKI (all p < 0.05). RNH1 serum levels before and RNase 1 serum levels 12 h after TAAA repair were significantly correlated with in-hospital mortality (both p < 0.05). On the basis of these findings, RNase 1 and RNH1 may be therapeutically relevant and may represent biomarkers for post-operative AKI and in-hospital mortality.
Highlights
Thoracoabdominal aortic surgery is associated with several post-operative complications and increased mortality [1]
We investigated the relationship between RNase 1 and RNase Inhibitor 1 (RNH1) serum levels and in-hospital mortality in patients undergoing open and endovascular thoracoabdominal aortic aneurysms (TAAA) repair, as well as the differences in these two surgical techniques
Ten patients undergoing open (71.4%) and seven (36.8%) undergoing endovascular TAAA repair developed post-operative acute kidney injury (AKI) as diagnosed according to the KDIGO classification criteria
Summary
Thoracoabdominal aortic surgery is associated with several post-operative complications and increased mortality [1]. Mortality is 8.3% 30 days after open surgery and 5.8% after endovascular surgery [2]. Multiple organ failure is one of the dreaded post-operative complications after open and endovascular surgical treatment of thoracoabdominal aortic aneurysms (TAAA). Acute kidney injury (AKI) is one of the most common organ failures after TAAA repair with an incidence between 13% and 42%. In addition to cardiovascular morbidity, AKI is associated with. 2 of 13 2 of 13 mortality [3,4,5]. AKI is diagnosed according to the Kidney Disease – Improving Global Outcomes (iKncDreIGasOed) cmritoerrtiaal.itAyc[c3o–r5d]i.nAg KtoI KisDdIiGaOgn, oAsKedI iascdcoiargdninogsetdo wthheeKnisdenreuymDcirseeaatsinei–neIminpcrroeavsinesgbGylo≥b0.a3l mOug/tcdolm(2e6s.5(KμDmIGolO/l)) cwriittehriina.4A8chcoorrdi≥n1g.5t-ofoKldD,IGorOw, AheKnI itshedrieaginsoaserdedwuhcteinonseirnumurcinreeavtionliunme ienctore
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