{"doi":"10.1093/ejcts/ezaf159","title":"Acute kidney injury and aorta-related mortality during open surgery of the abdominal aorta with suprarenal clamping using different renal protection strategies","abstract":"OBJECTIVES: The aim was to evaluate the incidence of acute kidney injury in patients treated with open surgical repair and suprarenal cross-clamp comparing no-perfusion strategy versus the renal perfusion with the histidine-tryptophan-ketoglutarate solution. METHODS: It is a physician-initiated, multicentre, retrospective observational study including patients treated with open surgical repair for abdominal aortic aneurysm between 1 January 2015 and 31 December 2021. Patients already on dialysis were excluded from the final analysis. A coarsened exact match identified 2 cohorts: no-perfusion strategy versus renal perfusion with the histidine-tryptophan-ketoglutarate solution. Primary outcomes were acute kidney injury incidence and survival at 30 day. Secondary outcomes were freedom from haemodialysis and survival at 1 year. RESULTS: We analysed 125 (28.7%) patients: 63 (14.5%) who did not receive renal perfusion and 62 (14.2%) who received the histidine-tryptophan-ketoglutarate perfusion. At 30 day, acute kidney injury rate (37.6%) was not different between the 2 groups [n = 24 (38.7%) vs 23 (36.5%); OR: 1.1, P = 0.855]. At 30 day, acute kidney injury development was associated with aneurysm extent (pararenal, OR: 2.28, 95% CI: 1.031-5.031, P = 0.042) and total time of intervention (threshold: 365 min, OR: 1.008, 95% CI: 1.003-1.012, P = 0.001). At 1 year, postoperative acute kidney injury did not impact mortality (OR: 3.4, P = 0.556), and freedom from haemodialysis was 100%. CONCLUSIONS: Postoperative acute kidney injury remains high at nearly 38%, but it did not impact on freedom from haemodialysis at 1 year as well as on overall survival.","journal":"European Journal of Cardio-Thoracic Surgery","year":2025,"id":552686,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":1,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9447,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1286041,"name":"Santi Trimarchi","orcid":"0000-0001-5996-3264","position":1,"is_corresponding":false},{"id":1449464,"name":"Stefano Bonardelli","orcid":null,"position":2,"is_corresponding":false},{"id":1449037,"name":"Valerio Tolva","orcid":"0000-0002-4642-0727","position":3,"is_corresponding":false},{"id":1449038,"name":"Efrem Civilini","orcid":"0000-0001-5180-8008","position":4,"is_corresponding":false},{"id":1449039,"name":"Giovanni Nano","orcid":"0000-0001-9680-6014","position":5,"is_corresponding":false},{"id":1449040,"name":"Raffaele Pulli","orcid":"0000-0003-1343-437X","position":6,"is_corresponding":false},{"id":1449041,"name":"Paolo Perini","orcid":"0000-0003-4554-416X","position":7,"is_corresponding":false},{"id":1449042,"name":"Sandro Lepidi","orcid":"0000-0003-2201-6081","position":8,"is_corresponding":false},{"id":506299,"name":"Filippo Benedetto","orcid":"0000-0001-7559-944X","position":9,"is_corresponding":false},{"id":1449043,"name":"Fabio Verzini","orcid":"0000-0003-4453-1949","position":10,"is_corresponding":false},{"id":1449044,"name":"Gian Franco Veraldi","orcid":"0000-0002-3351-3158","position":11,"is_corresponding":false},{"id":1449045,"name":"Domenico Angiletta","orcid":"0000-0002-6135-836X","position":12,"is_corresponding":false},{"id":1449046,"name":"Raffaello Bellosta","orcid":"0000-0003-4803-6566","position":13,"is_corresponding":false},{"id":1449465,"name":"CLAMPS (Clamping the Suprarenal Aorta With Multiple Perfusion Strategy) Group","orcid":null,"position":14,"is_corresponding":false},{"id":1449047,"name":"Marco Franchin","orcid":"0000-0002-4193-1923","position":15,"is_corresponding":false},{"id":1449466,"name":"Francesca Mauri","orcid":null,"position":16,"is_corresponding":false},{"id":1449048,"name":"Matteo Tozzi","orcid":"0000-0002-7300-8260","position":17,"is_corresponding":false},{"id":1449049,"name":"Chiara Lomazzi","orcid":"0000-0003-0172-1291","position":18,"is_corresponding":false},{"id":1449050,"name":"Viviana Grassi","orcid":"0000-0002-8206-3042","position":19,"is_corresponding":false},{"id":1449051,"name":"Irene Fulgheri","orcid":"0000-0002-6177-0688","position":20,"is_corresponding":false},{"id":1449052,"name":"Ilenia D’Alessio","orcid":"0000-0001-8275-6394","position":21,"is_corresponding":false},{"id":1449053,"name":"Nicola Monzio Compagnoni","orcid":"0000-0001-8731-7374","position":22,"is_corresponding":false},{"id":1449054,"name":"Maria Giulia Pascucci","orcid":"0000-0001-5433-7352","position":23,"is_corresponding":false},{"id":1449467,"name":"E. 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