{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T06:05:10Z","timestamp":1769666710868,"version":"3.49.0"},"reference-count":21,"publisher":"Centre for Evaluation in Education and Science (CEON\/CEES)","issue":"1","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/BY\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Med Biochemistry"],"published-print":{"date-parts":[[2026]]},"abstract":"<jats:p>Background: This study aimed to develop an early prediction model for postoperative acute kidney injury (AKI) in patients with acute type A aortic dissection (ATAAD) undergoing total  a  rch replacement (TAR) combined with frozen elephant trunk (FET) implantation. Specifically, it investigated the association between preoperative cystatin C levels and postoperative AKI while incorporating other relevant risk factors into the analysis. Methods: A single-centre case-control study was conducted, including 202 patients treated between January 2018 and December 2019. Patients were divided into an AKI group (n=73) and a non-AKI group (n = 129) based on postoperative renal outcomes. Results: Univariate analysis revealed that a preoperative history of hypertension (P = 0.013), white blood cell (WBC) count (P&amp;lt; 0.001), serum creatinine (P &amp;lt; 0.001), blood urea nitrogen (P &amp;lt; 0.001), and cystatin C (P&amp;lt; 0.001) were significantly associated with postoperative AKI. Postoperative variables, including duration of mechanical ventilation (P&amp;lt; 0.001), length of ICU stay (P&amp;lt; 0.001), acute respiratory failure (P = 0 .0 1 8 ), acute cerebrovascular events (P= 0.042), and 30-day mortality (P&amp;lt; 0.001) also differed significantly between groups. Multivariate logistic regression incorporating preoperative variables identified cystatin C (OR: 11.541, 95% CI: 3.811 -34.953 , P&amp;lt; 0.001), WBC count (OR: 1.122, 95% CI: 1.013-1.242, P= 0.028), and history of hypertension (OR: 3.080, 95% CI: 1.188-7.990) as independent risk factors for postoperative AKI. Survival analysis further confirmed a significant association between preoperative cystatin C levels and the incidence of AKI in both crude and subgroup analyses. A clinical prediction model was developed based on the multivariate results. Internal validation showed a concordance index (C-index) of 0.804 for the training set and 0.609 for the validation set. Conclusions: Preoperative cystatin C level was identified as an independent predictor of postoperative AKI. Incorporating cystatin C with other preoperative clinical risk factors may enhance the predictive accuracy for postoperative AKI in patients with ATAAD undergoing total arch replacement with FET implantation.<\/jats:p>","DOI":"10.5937\/jomb0-56220","type":"journal-article","created":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T07:09:10Z","timestamp":1753859350000},"page":"150-159","source":"Crossref","is-referenced-by-count":0,"title":["Prediction value of cystatin C for postoperative acute kidney injury of acute type A aortic dissection"],"prefix":"10.5937","volume":"45","author":[{"given":"Shouming","family":"Li","sequence":"first","affiliation":[{"name":"Beijing Anzhen Hospital, Capital Medical University, Department of Cardiovascular Surgery, Beijing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xin","family":"Zhao","sequence":"additional","affiliation":[{"name":"Qilu Hospital of Shandong University, Department of Cardiovascular Surgery, Jinan, Shandong Province, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhenhua","family":"Wang","sequence":"additional","affiliation":[{"name":"Qilu Hospital of Shandong University, Department of Cardiovascular Surgery, Jinan, Shandong Province, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Han","family":"Song","sequence":"additional","affiliation":[{"name":"Qilu Hospital of Shandong University, Department of Cardiovascular Surgery, Jinan, Shandong Province, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yongmin","family":"Liu","sequence":"additional","affiliation":[{"name":"Beijing Anzhen Hospital, Capital Medical University, Department of Cardiovascular Surgery, Beijing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"3964","reference":[{"key":"ref1","doi-asserted-by":"crossref","unstructured":"Musajee M, Katsogridakis E, Kiberu Y, Banerjee C, George R, Modarai B, et al. Acute Kidney Injury in Patients with Acute Type B Aortic Dissection. European journal of vascular and endovascular surgery: the official journal of the European Society for Vascular Surgery 2023; 65: 256-62. doi:10.1016\/j.ejvs.2022.10.032;","DOI":"10.1016\/j.ejvs.2022.10.032"},{"key":"ref2","doi-asserted-by":"crossref","unstructured":"Arnaoutakis GJ, Ogami T Patel HJ, Pai CW, Woznicki EM, Brinster DR, et al. Acute Kidney Injury in Patients Undergoing Surgery for Type A Acute Aortic Dissection. The Annals of Thoracic Surgery 2023; 115: 879-85. doi:10.1016\/j.athoracsur.2022.10.037;","DOI":"10.1016\/j.athoracsur.2022.10.037"},{"key":"ref3","doi-asserted-by":"crossref","unstructured":"Helgason D, Helgadottir S, Ahlsson A, Gunn J, Hjortdal V, Hansson EC, et al. Acute Kidney Injury After Acute Repair of Type A Aortic Dissection. 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