Renal Artery Involvement Predicts Renal Atrophy without Affecting AKI Incidence after TEVAR in DeBakey IIIb Aortic Dissection: A Single-Center Retrospective Analysis.

BACKGROUND: To investigate whether preoperative renal artery involvement independently predicts postoperative acute kidney injury (AKI) and renal atrophy in patients with DeBakey IIIb aortic dissection who underwent thoracic endovascular aortic repair (TEVAR), and to explore the association between AKI and renal atrophy.

METHODS: Retrospective analysis of 82 patients was performed. AKI was defined per Kidney Disease: Improving Global Outcomes (KDIGO) criteria. Renal atrophy was defined as a renal length reduction >1.00 cm. Univariate analysis compared clinical variables between groups, while binary logistic regression analyzed AKI risk factors and generalized estimating equations (GEEs) identified independent predictors of renal atrophy.

RESULTS: Patients with renal artery involvement had higher postoperative serum creatinine and lower preoperative/postoperative estimated glomerular filtration rate (P < 0.05). AKI incidence was identical between groups (9.76% each, P = 1.00). GEE analysis showed renal artery involvement was an independent predictor of renal atrophy [odds ratio (95% confidence interval): 4.71 (1.94-11.44), P = 0.001]. No factors were significantly associated with AKI in logistic regression.

CONCLUSION: Preoperative renal artery involvement does not correlate with postoperative AKI but independently predicts long-term renal atrophy after TEVAR in DeBakey IIIb dissection.