Evidence map›Paper›PMID 40341329›Full record

Observational studyEuropean journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery2025

Acute kidney injury and aorta-related mortality during open surgery of the abdominal aorta with suprarenal clamping using different renal protection strategies.

Gabriele Piffaretti, Santi Trimarchi, Stefano Bonardelli, Valerio Tolva, Efrem Civilini, Giovanni Nano, Raffaele Pulli, Paolo Perini, Sandro Lepidi, Filippo Benedetto and 5 more

Erratum issuedAbstract readObservational StudyMulticenter Study
In one paragraph

Observational study in European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

15 authors.

Gabriele PiffarettiVascular Surgery-Department of Medicine and Surgery, University of Insubria Faculty of Medicine and Surgery, Varese, Italy.ORCID 0000-0002-9906-4658
Santi TrimarchiVascular Surgery, University of Milan, Milan, Italy.ORCID 0000-0001-5996-3264
Stefano BonardelliVascular Surgery, University of Brescia, Brescia, Italy.
Valerio TolvaVascular and Endovascular Surgery Unit, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy.
Efrem CiviliniVascular Surgery-Department of Biomedical Sciences, IRCCS Humanitas University Hospital, Rozzano, Italy.ORCID 0000-0001-5180-8008
Giovanni NanoVascular Surgery-IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy.
Raffaele PulliVascular Surgery, University of Florence, Florence, Italy.
Paolo PeriniVascular Surgery, University of Parma, Parma, Italy.
Sandro LepidiVascular and Endovascular Surgery, University of Trieste, Trieste, Italy.
Filippo BenedettoVascular Surgery, University of Messina, Messina, Italy.
Fabio VerziniVascular Surgery, University of Turin, Turin, Italy.
Gianfranco VeraldiVascular Surgery, Integrated University Hospital of Verona, Verona, Italy.
Domenico AngilettaVascular Surgery, University of Bari School of Medicine, Bari, Italy.ORCID 0000-0002-6135-836X
Raffaello BellostaVascular Surgery, Poliambulanza Foundation, Brescia, Italy.ORCID 0000-0003-4803-6566
CLAMPS (Clamping the Suprarenal Aorta With Multiple Perfusion Strategy) Group

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesThe 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.

methodsIt 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.

resultsWe 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%.

conclusionsPostoperative 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.

Indexed as

Acute Kidney InjuryAorta, AbdominalAortic Aneurysm, AbdominalAgedConstrictionFemaleGlucoseHumansIncidenceMaleMannitolMiddle AgedPerfusionPotassium ChlorideProcaineRetrospective StudiesBretschneider cardioplegic solutionGlucoseMannitolPotassium ChlorideProcaineAcute kidney injuryCustodiol®Histidine-tryptophan-ketoglutarateJuxtarenal aortic aneurysmOpen surgical repairPararenal aortic aneurysmSuprarenal clamping

Identifiers

PMID40341329
PMCPMC12399282

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.