Kidney Week

Abstract: FR-PO0053

Development of a Predictive Model for Acute Kidney Disease Following Stanford Type A Aortic Dissection Surgery

Session Information

• AKI: Epidemiology, Risk Factors, and Prevention
  November 07, 2025 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Acute Kidney Injury

• 101 AKI: Epidemiology, Risk Factors, and Prevention

Authors

• Gu, Yue, Henan Provincial People's Hospital, Zhengzhou, Henan, China

Yue Gu, DrMed, PhD

• Lu, Lizhen, Henan Provincial People's Hospital, Zhengzhou, Henan, China

Lizhen Lu, APN

• Zhou, Jing, Henan Provincial People's Hospital, Zhengzhou, Henan, China

Jing Zhou, PhD

• Shao, Fengmin, Henan Provincial People's Hospital, Zhengzhou, Henan, China

Fengmin Shao, MD, PhD

Background

About 1/3 of Stanford type A aortic dissection (TAAD) patients with postoperative acute kidney injury (AKI) progress to acute kidney disease (AKD). Lack of validated predictive tools impedes timely intervention during renal recovery.

Methods

This retrospective cohort included 290 TAAD patients with postoperative AKI after TAAD surgery. Based on serum creatinine (Scr) levels at 7 days post-AKI diagnosis, patients were categorized into AKD (n=134) and non-AKD (n=156) groups. Multivariable logistic regression identified predictors; a nomogram was constructed.

Results

AKD incidence was 46.2% (134/290). Cohort characteristics were 74.8% male, mean age 52.3±11.6 years. The AKD group demonstrated higher preoperative white blood cell counts (11.61×10⁹/L vs 11.35×10⁹/L,P=0.045), uric acid levels (339.00 μmol/L vs 335.00 μmol/L,P=0.013), and rates of renal malperfusion (64.9% vs 50.6%,P=0.014), AKI stage 3 (55.2% vs 10.9%, P<0.001), and prolonged mechanical ventilation (87.3% VS 67.4%,P<0.001), and lower postoperative digoxin use (21.0% vs 44.9%, P<0.001). Independent predictors (Table 1) included preoperative renal malperfusion (OR=2.41,95% CI 1.16-5.01), AKI stage 2 (OR=4.38, 95% CI 2.02-9.50), AKI stage 3 (OR=18.70, 95% CI 7.39-47.17), and prolonged mechanical ventilation (OR=3.57, 95% CI 1.56-8.18). Digoxin use showed a protective effect (OR=0.46, 95% CI 0.23-0.92). The nomogram （Fig 1）demonstrated strong discrimination (AUC=0.842) and calibration (Brier score=0.160, χ²=6.48, P=0.594).

Conclusion

Our nomogram enables early risk stratification to guide personalized management.

Postoperative AKD independent predictors in Stanford Type A Aortic Dissection

Digital Object Identifier (DOI)

• doi: 10.1681/ASN.2025arhrzv5h