Clinical Research Directory

Preoperative Ankle-Brachial Index and Renal Adverse Events After Acute Type A Aortic Dissection Surgery

This single-centre retrospective observational cohort study evaluated the association between preoperative cuff-derived ankle-brachial index (ABI) and postoperative acute kidney injury (AKI) in adults undergoing emergency repair of acute type A aortic dissection. Existing clinical data from patients treated at Nanjing First Hospital, Nanjing Medical University, between January 2019 and February 2024 were used. High ABI was defined as \>1.40, and the reference ABI range was defined as \>0.90 and ≤1.40. The primary outcome was creatinine-defined AKI within 7 postoperative days. Exploratory analyses examined whether the association between cumulative intraoperative mean arterial pressure exposure and AKI differed according to ABI phenotype. No intervention or treatment allocation was assigned by the study protocol.

Renal Near-Infrared Spectroscopy Monitoring and Postoperative Acute Kidney Injury in Cardiac Surgery

This prospective observational study aims to evaluate the effectiveness of renal near-infrared spectroscopy (NIRS) monitoring in predicting postoperative acute kidney injury (AKI) in patients undergoing elective cardiac surgery with cardiopulmonary bypass. Acute kidney injury is a common and serious complication after cardiac surgery and is associated with increased morbidity and mortality. A total of 115 adult patients scheduled for elective coronary artery bypass grafting or heart valve surgery using cardiopulmonary bypass will be included in the study. Renal and cerebral tissue oxygen saturation will be continuously monitored intraoperatively using near-infrared spectroscopy. Hemodynamic parameters, operative variables, and laboratory results will also be recorded. Postoperative kidney function will be evaluated according to KDIGO criteria based on serum creatinine levels and urine output. Patients will be classified into two groups according to the presence or absence of postoperative acute kidney injury. The aim of this study is to investigate whether intraoperative renal NIRS monitoring can be used as an early indicator for the development of acute kidney injury in patients undergoing cardiac surgery with cardiopulmonary bypass.