Abstract Body (Do not enter title and authors here):
Background
Acute Kidney Injury (AKI) is a multifactorial complication following repair of Stanford Type A aortic dissection (TAAD) with an alarmingly high incidence, varying from 20 to 77%. Postoperative AKI following life-threatening disease tends to be much more complex. However, the exact role of postprocedural AKI in the prognosis of patients undergoing TAAD repair has not been elucidated.

Aims
This meta-analysis aimed to evaluate the prognostic significance of postprocedural AKI in patients undergoing TAAD repair.

Methods
A literature search was conducted using PubMed, EMBASE, and SCOPUS databases. The primary endpoint was 30-day mortality with several secondary endpoints. Risk ratios (RR) with 95% confidence intervals (CIs) were pooled using Review Manager software. Statistical significance was set at p <0.05. Random-effects meta-analyses were performed for all outcomes.

Results
Our analysis included 21 studies comprising 10396 patients. Patients with AKI exhibited a significantly higher risk of 30-day mortality (RR=3.98; 95% CI: 3.04-5.22; p<0.00001; I²=57%), stroke (RR= 2.05; 95% CI: 1.68-2.50; p<0.00001; I²=32%), dialysis requirement (RR= 32.9; 95% CI: 10.39-104.24; p<0.00001; I²=90%) (Figure 1), cardiovascular complications (RR= 2.85; 95% CI: 1.65-4.92; p<0.0002; I²=85%), sepsis (RR= 4.92; 95% CI: 2.62-9.24; p<0.00001; I²=64%), and re-exploration for bleeding (RR=2.46; 95%CI: 1.79-3.39; p<0.00001; I²=58%) compared to those without AKI (Figure 2).

Conclusion
Patients with AKI demonstrated a significantly increased risk of mortality, stroke, need for dialysis, sepsis, postoperative cardiovascular complications, and re-exploration for bleeding. Further prospective studies are required to better understand the prevention strategies and long-term effects on prognosis of AKI post-repair for TAAD.