ISSN 1006-298X      CN 32-1425/R

Chinese Journal of Nephrology, Dialysis & Transplantation ›› 2021, Vol. 30 ›› Issue (3): 228-233.DOI: 10.3969/j.issn.1006298X.2021.03.007

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Clinical characteristics and prognosis of acute aortic dissection with kidney injury

  

  • Online:2021-06-28 Published:2021-06-22

Abstract: Objective:To summarize the characteristics and prognostic outcome of acute aortic dissection which was symbolic of kidney injury.
Methodology:Retrospective analysis of clinical manifestations, laboratory examinations and prognostic outcomes of patients who were diagnosed with acute aortic dissection those with the presentation of kidney injury from January 2010 to December 2020.
Results:8 patients complain of kidney injury as the first symptom and diagnosed with acute aortic dissection, including 3 cases of type A and five of type B. 7 patients had history of hypertension and poor blood pressure controlling, 1 has the typical presentation of Marfan syndrome. The extrarenal manifestations are mainly intermittent back pain or abdominal pain and limb numbness. Most patients present with acute kidney injury, and progressed to quickly anuria and hemodialysis (6±2 day). Compare with the no kidney injury patient, nearly all patients had a high level of probrain natriuretic peptide and ddimer. 7 patients received surgery. During the followup, 1 case was lost, 7 cases survived, of which 3 cases were free of hemodialysis and 4 cases had need maintance dialysis treatment.
Conclusion:Patients with unexplained kidney injury combined with the following characteristics should consider the possibility of acute aortic dissection: history of hypertension with poor controlling or a typical Marfan’s syndrome features: Waist and abdominal pain, numbness of limbs and other manifestations during the onset; Nterminal probrain natriuretic peptide or Ddimer increased significantly.