Post-Operative Kidney Function Using Deep Hypothermic Circulatory Arrest (DHCA) in Aortic Arch Operation

Masahide Higo,1 Yoshio Shimizu,2,3 Keiichi Wakabayashi,2 Takehiko Nakano,1 Yasuhiko Tomino,4 Yusuke Suzuki5 1Department of Clinical Engineering, Juntendo University Shizuoka Hospital, Izunokuni, Shizuoka, Japan; 2Division of Nephrology, Department of Internal Medicine, Juntendo University Shizuoka Hospital, Izunokuni, Shizuoka, Japan; 3Shizuoka Medical Research Center for Disaster, Juntendo University, Izunokuni, Shizuoka, Japan; 4Asian Pacific Renal Research Promotion Office, Medical Corporation SHOWAKAI, Shinjuku-ku, Tokyo, Japan; 5Department of Nephrology, Juntendo University Faculty of Medicine, Tokyo, JapanCorrespondence: Yoshio Shimizu, Division of Nephrology, Department of Internal Medicine, Juntendo University Shizuoka Hospital, 1129 Nagaoka, Izunokuni-shi, Shizuoka, 410-2211, Japan, Tel +81-55-948-3111, Fax +81-55-946-0858, Email yosimizu@juntendo.ac.jpBackground: Although deep hypothermic circulatory arrest (DHCA) is a useful option to protect the central nervous system during aortic arch operations, the influence of simultaneous renal ischemia remains controversial.Patients and Methods: This is a retrospective observational study. Sixty-three patients who underwent thoracic aortic surgery with DHCA and 24 patients who underwent cardiac surgery without DHCA were included in this study. The mean age, preoperative serum creatinine (Cr) level, preoperative estimated glomerular filtration rate (eGFR), peak serum Cr level up to 48 hrs post-operative, elevation rate of Cr compared to the preoperative serum Cr, urine volume rate up to 48 hrs post-operative and AKI staging using the KDIGO criteria were estimated for each patient. Clinical parameters for 3 months after the operation and the 3-month post-operative mortality rate were assessed. Mean values indicating kidney function or distribution of the AKI stages were compared between patients with and without DHCA. Patients with DHCA were further divided according to the duration of ischemia to compare the values