Objective This study assessed renal perfusion using bilateral renal ultrasonography with color Doppler flow imaging (CDFI) and contrast‐enhanced ultrasound (CEUS) to predict acute kidney injury (AKI) progression after acute Type A aortic dissection (ATAAD) surgery. Methods In this prospective single‐center cohort study, postoperative ATAAD patients with AKI were enrolled. AKI lasting over 7 days was defined as acute kidney disease (AKD). Bilateral CDFI and CEUS were conducted within 24 h of AKI diagnosis to measure peak systolic velocity (PSV), renal resistance index (RRI), and peak intensity (PI). Kidneys were categorized into high‐perfusion (Group 1, PI1) and low‐perfusion (Group 2, PI2) based on PI. Preoperative CTA provided renal artery blood supply (RA) data. Patient progression to AKD was tracked. Results From February 2022 to June 2024, 93 patients (median age 53, 83 males, 10 females) were included. Of these, 29 (31.2%) recovered renal function within 7 days, while 64 (68.8%) progressed to AKD. Thirty‐five patients (37.6%) needed continuous renal replacement therapy (CRRT). Univariable analysis linked PSV1, PSV2, RRI2, RA2, and PI2 to renal outcomes. Six parameters, including RA1 ( p 0.75, and PSV2 ≤ 28.62 cm/s. Conclusion Parameters from CDFI and CUES can form a multiparameter model to predict AKI progression post‐ATAAD surgery. Perfusion markers from the more hypoperfused kidney offer a better prognostic value for early postoperative renal risk assessment.
Li et al. (Thu,) studied this question.