Cardiothoracic & vascular anesthesia
Hemolysis and Acute Kidney Injury Following Cardiac Surgery With Cardiopulmonary Bypass in Patients With Preexisting Renal Dysfunction
Authors' conclusion
This study demonstrates that CPB induces hemolysis and endothelial activation and damage in patients with preexisting renal dysfunction. Although CFHb concentrations were higher in those developing AKI, CFHb did not predict AKI or correlate with markers of endothelial damage.
Study context
- Population
- Adults undergoing cardiac surgery with cardiopulmonary bypass (CPB) and estimated glomerular filtration rate (eGFR) <50 mL/min/1.73 m² or DM with eGFR <60 mL/min/1.73 m²
- Participants
- 89 adults
Methodological detailsSecondary referral and tertiary hospital, Plasma samples after induction of anaesthesia, within 1 hour at ICU, and 24 and 48 hours postoperatively
- Secondary referral and tertiary hospital
- Plasma samples after induction of anaesthesia, within 1 hour at ICU, and 24 and 48 hours postoperatively
Primary result
As reported in the abstract
- Postoperative acute kidney injury (AKI)
- 21%
- Cell-free hemoglobin (CFHb) peak at 1 hour postoperatively (vs baseline)
- 22.5 v 5.4 mg/dL, p < 0.001
- Adding CFHb to AKI prediction model: model fit
- p = 0.28
- Adding CFHb to AKI prediction model: discrimination
- p = 0.32
Further findings
Lactate dehydrogenase · 48 hours postoperatively
- Rose until 48 hours postoperatively
- 119 v 339 U/L, p < 0.001
Tumor necrosis factor α and intercellular adhesion molecule 1
- Tumor necrosis factor α increased after surgery
- 7.06 v 9.21 ng/mL, p = 0.020
- Intercellular adhesion molecule 1 increased after surgery
- 247 v 388 ng/mL, p < 0.001
Angiopoietin-2, AKI vs no AKI · 24 hours
- Rose until 48 hours postoperatively; higher in patients with AKI at 24 hours
- 4,162 v 3,374 pg/mL, p = 0.027
Neutrophil gelatinase-associated lipocalin
- Increased in patients with AKI
- 43.1 v 88.0 ng/mL, p < 0.001
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Hemolysis and Acute Kidney Injury Following Cardiac Surgery With Cardiopulmonary Bypass in Patients With Preexisting Renal Dysfunction. J Cardiothorac Vasc Anesth. Published 25 February 2026. doi:10.
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