{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T12:18:24Z","timestamp":1783426704411,"version":"3.54.6"},"reference-count":27,"publisher":"MDPI AG","issue":"13","license":[{"start":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T00:00:00Z","timestamp":1782950400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Tricuspid valve surgery carries a high risk of postoperative acute kidney injury (AKI) due to pre-existing right ventricular dysfunction and congestive end-organ remodeling. We aimed to evaluate the incidence and predictors of postoperative AKI, with particular focus on the prognostic value of the TAPSE\/sPAP index. Methods: This retrospective, single-center study evaluated adult patients who underwent tricuspid valve surgery (isolated\/concomitant) between 2010 and 2025. The primary outcome was postoperative AKI of any stage, defined by the Kidney Disease: Improving Global Outcomes (KDIGO) criteria. Predictors were identified using a pre-specified multivariable logistic regression model including baseline estimated glomerular filtration rate (eGFR), cardiopulmonary bypass time, and EuroSCORE II; TAPSE\/sPAP associations with severe renal outcomes were assessed univariably and presented as exploratory. Results: Of 80 patients, postoperative AKI occurred in 32 (40.0%), with 16 (20.0%) requiring renal replacement therapy. The pre-specified multivariable model discriminated any-stage AKI (AUC 0.86, 95% CI 0.77\u20130.94). Lower baseline eGFR (adjusted OR 1.82 per 10 mL\/min\/1.73 m2 decrease, p &lt; 0.001) and higher EuroSCORE II (adjusted OR 1.53 per point, p = 0.03) were independent predictors. The TAPSE\/sPAP index was not associated with any-stage AKI (p = 0.42), but lower values predicted advanced renal outcomes, including KDIGO stage \u2265 2 AKI (OR 2.11, p = 0.03) and the requirement for renal replacement therapy (OR 2.71, p = 0.01). Outcomes did not differ between isolated (n =14) and combined procedures (n = 66; AKI 35.7% vs. 40.9%, p = 0.77). Conclusions: Lower preoperative eGFR and higher EuroSCORE II independently predict any-stage postoperative AKI. In univariable analysis, the TAPSE\/sPAP index identified the subgroup with severe renal outcomes; this exploratory finding requires prospective validation. Whether perioperative renal protection depends on addressing right-sided filling pressures rather than augmenting forward flow alone requires prospective testing.<\/jats:p>","DOI":"10.3390\/jcm15135155","type":"journal-article","created":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T11:48:32Z","timestamp":1782992912000},"page":"5155","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Incidence and Predictors of Acute Kidney Injury Following Tricuspid Valve Surgery: The Prognostic Value of Right Ventricular Length\u2013Force Relationship"],"prefix":"10.3390","volume":"15","author":[{"given":"Sercan","family":"Tak","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Surgery, Faculty of Medicine, Gazi University, Ankara 06560, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1382-2439","authenticated-orcid":false,"given":"\u00d6zant","family":"Helvac\u0131","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Faculty of Medicine, Gazi University, Ankara 06560, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erkan","family":"\u0130riz","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Faculty of Medicine, Gazi University, Ankara 06560, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hikmet Sel\u00e7uk","family":"Gedik","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Faculty of Medicine, Gazi University, Ankara 06560, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mustafa Hakan","family":"Zor","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Faculty of Medicine, Gazi University, Ankara 06560, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdullah","family":"\u00d6zer","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Faculty of Medicine, Gazi University, Ankara 06560, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ba\u015fak","family":"Ko\u00e7ak","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Faculty of Medicine, Gazi University, Ankara 06560, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yonca","family":"Durkan","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Faculty of Medicine, Gazi University, Ankara 06560, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2125-5881","authenticated-orcid":false,"given":"Taha Enes","family":"\u00c7etin","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Faculty of Medicine, Gazi University, Ankara 06560, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G\u00fcrsel Levent","family":"Oktar","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Faculty of Medicine, Gazi University, Ankara 06560, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,2]]},"reference":[{"key":"ref_1","first-page":"437","article-title":"Acute Kidney Injury after Cardiac Surgery","volume":"14","author":"Beaver","year":"2024","journal-title":"Cardiorenal Med."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Wang, X.D., Bao, R., Lan, Y., Zhao, Z.Z., Yang, X.Y., Wang, Y.Y., Quan, Z.Y., Wang, J.F., and Bian, J.J. 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Imaging"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/13\/5155\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T11:37:11Z","timestamp":1783424231000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/13\/5155"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,2]]},"references-count":27,"journal-issue":{"issue":"13","published-online":{"date-parts":[[2026,7]]}},"alternative-id":["jcm15135155"],"URL":"https:\/\/doi.org\/10.3390\/jcm15135155","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,2]]}}}