Cardiothoracic & vascular anesthesia
Acute normovolemic hemodilution and cardiac surgery-associated acute kidney injury: a retrospective cohort study
Main finding · Postoperative RRTResult — go to the resultRelative risk 0.63 95% CI 0.43–0.92Authors' conclusion
In elective cardiac surgery, ANH was associated with reduced postoperative RRT and allogeneic transfusion requirements; however, residual confounding may persist, requiring confirmation in future studies.
Study context
- Population
- Patients undergoing elective cardiac surgery, JMDC Hospital database, Japan, 1 April 2016 to 31 May 2023
- Participants
- 19,387 patients
- Exposure
- Acute normovolemic hemodilution (ANH) vs no ANH in elective cardiac surgery
- ANHn = 1,644
- non-ANHn = 1,639reference
- Outcome
- Initiation of renal replacement therapy (RRT) within 7 days postoperatively (cardiac surgery-associated acute kidney injury (CSA-AKI))
- Follow-up
- 7 days postoperatively
Methodological detailsmarginal structural models with standardized mortality ratio weighting based on the propensity score, JMDC Hospital database
- Marginal structural models with standardized mortality ratio weighting based on the propensity score
- JMDC Hospital database
Main finding
Postoperative RRT
Relative risk
0.63
95% CI 0.43–0.92
P = 0.02
Events by group
ANH vs non-ANH
RR 0.63 (95% CI 0.43–0.92); P = 0.02
As reported in the abstract
Observational data: associations, not effects.
Secondary outcomes
Allogeneic blood transfusion units on the day of surgery
- Fewer units required in the ANH group
In-hospital mortality
- No significant difference between groups
Original publication
Acute normovolemic hemodilution and cardiac surgery-associated acute kidney injury: a retrospective cohort study. Can J Anaesth. Published 15 April 2026. doi:10.
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