An observational study in Aortic Dissection Type A and Acute Kidney Injury Cardiac Surgery, sponsored by Nanjing First Hospital, Nanjing Medical University. Completed at 1 site in China. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-09-21.
Sponsored by Nanjing First Hospital, Nanjing Medical University · Observational
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.
This is a single-centre retrospective observational cohort study using routinely collected electronic health records from adults undergoing emergency open repair of acute type A aortic dissection at Nanjing First Hospital, Nanjing Medical University, between January 2019 and February 2024. No study-specific intervention, treatment allocation, or additional clinical follow-up was performed.
The principal exposure was preoperative cuff-derived ankle-brachial index (ABI). ABI was calculated from routine four-limb oscillometric cuff pressures. Each ankle systolic pressure was divided by the higher brachial systolic pressure, and the higher of the two side-specific ABI values was used for patient classification. High ABI was defined as >1.40, and the reference ABI range was defined as >0.90 and ≤1.40. ABI was considered an indirect vascular phenotype marker rather than a direct measure of arterial stiffness or renal autoregulatory reserve.
The primary outcome was postoperative acute kidney injury (AKI) within 7 days, defined using serum creatinine-based Kidney Disease: Improving Global Outcomes criteria. Multivariable regression models were used to evaluate the association between high ABI and postoperative AKI after adjustment for relevant clinical and operative covariates.
Exploratory analyses assessed whether the association between cumulative intraoperative mean arterial pressure (MAP) burden and postoperative AKI differed according to ABI phenotype. Cumulative MAP burden below 65 and 80 mm Hg was evaluated. The candidate haemodynamic thresholds were informed in part by preliminary data exploration; these interaction analyses were therefore considered hypothesis-generating and were not intended to identify physiological or treatment thresholds.
Nanjing First Hospital, Nanjing Medical University is the lead sponsor of 213 studies on the registry; 106 are open to participants now.
Counted across the registry records on this site, refreshed daily.
The study population comprised consecutive adults with acute type A aortic dissection who underwent emergency open surgical repair at Nanjing First Hospital, Nanjing Medical University, between January 2019 and February 2024. Eligible patients were identified retrospectively from existing hospital medical records. Inclusion required routine preoperative four-limb cuff pressure measurements sufficient for ABI derivation and postoperative serum creatinine data sufficient for AKI ascertainment. Patients meeting the prespecified exclusion criteria, including ABI ≤0.90, advanced preoperative kidney dysfunction, severe preoperative heart failure, or imaging-confirmed renal or limb malperfusion, were excluded.
Exclusion Criteria
Patients with acute type A aortic dissection who underwent emergency surgical repair and had a preoperative cuff-derived ABI \>1.40.
Other: Preoperative Ankle-Brachial Index
Patients with acute type A aortic dissection who underwent emergency surgical repair and had a preoperative cuff-derived ABI \>0.90 and ≤1.40.
Other: Preoperative Ankle-Brachial Index
Preoperative ABI was derived from routine four-limb oscillometric cuff pressure measurements. Each ankle systolic pressure was divided by the higher brachial systolic pressure, and the higher of the two side-specific ABI values was used for patient classification. High ABI was defined as \>1.40 and reference ABI as \>0.90 and ≤1.40. No intervention was assigned by the study protocol.
Postoperative Acute Kidney Injury
Postoperative acute kidney injury was defined according to serum creatinine-based Kidney Disease: Improving Global Outcomes criteria. Acute kidney injury was identified if serum creatinine increased by at least 0.3 mg/dL within 48 hours after surgery or increased to at least 1.5 times the baseline value within 7 days after surgery.
Time frame: Within 7 days after surgery
Postoperative Acute Kidney Disease
Postoperative acute kidney disease was assessed using postoperative renal function data after the acute kidney injury window, according to changes in serum creatinine and renal function during the postoperative period.
Time frame: Within 7 to 90 days after surgery
Plan to share: No — Individual participant data will not be shared because this retrospective study uses existing hospital medical records containing sensitive clinical information. Data sharing is restricted by institutional policies and privacy considerations. De-identified aggregate results may be made available in the publication or from the corresponding author upon reasonable request, subject to institutional approval.
No publications or documents are linked to this record.
This study is completed, as verified in Jun 2026. You cannot join it, but the record below documents what was studied.
Get an email when the registry record changes — status, dates, results — or when someone posts here.
Sign in to followQuestions and observations about this study, from anyone following it. Not medical advice, and not a channel to the study team — their contact details are on the registry record.
Sign in to join the discussion. Reading takes no account; posting does. You choose a display name, and a pseudonym is the default.
Nothing here yet. If you are running this trial, taking part in it, or weighing whether to, this is the place to say so.
Nanjing First Hospital, Nanjing Medical University