Cardiothoracic & vascular anaesthesia
Acute Kidney Injury After Cardiac Surgery: A Systematic Review of Pharmacological and Non-Pharmacological Interventions
Authors' conclusion
Only a limited number of interventions were associated with lower odds of CSA-AKI
Study context
- Population
- Adults undergoing cardiac surgery
- Participants
- 63,785 adults · 207 randomized controlled trials (RCTs)
- Comparison
- Pharmacological and non-pharmacological interventions to prevent cardiac surgery-associated AKI vs control
- Outcome
- Cardiac surgery-associated acute kidney injury (CSA-AKI) (interventions in ≥4 RCTs)
Methodological detailsqualitative synthesis, meta-analysis when at least 4 RCTs available
- Qualitative synthesis
- Meta-analysis when at least 4 RCTs available
Pooled result
As reported in the abstract
Odds ratio (95% CI)
Dexmedetomidine
0.48(0.29–0.80)
Fenoldopam
0.57(0.33–0.98)
Nitric oxide
0.61(0.43–0.88)
Remote ischemic preconditioning
0.78(0.67–0.90)
Further pooled results
Characteristics and results of included RCTs
- Interventions evaluated
- 55
- Median sample size
- 120
- Single-centre
- 76.7%
- Neutral results
- 149/206
- Reported benefit
- 49
- Reported harm
- 8
- N-Acetylcysteine RCTs (most studied pharmacological)
- 19
- Remote ischemic preconditioning RCTs (most studied non-pharmacological)
- 34
Interventions evaluated in <4 RCTs
- Signals of benefit for amino acids, atrial natriuretic peptide, goal-directed perfusion, and KDIGO-based care bundles
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Acute Kidney Injury After Cardiac Surgery: A Systematic Review of Pharmacological and Non-Pharmacological Interventions. J Cardiothorac Vasc Anesth. Published 18 September 2026. doi:10.
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