Cardiothoracic & vascular anaesthesia
Intraoperative hemoadsorption and cardiac surgery-associated acute kidney injury: an updated systematic review and meta-analysis with trial sequential analysis
Pooled result · CSA-AKIResult — go to the resultRelative risk 0.80 95% CI 0.63–1.03Authors' conclusion
Intraoperative hemoadsorption did not significantly reduce CSA-AKI or improve clinical outcomes in adult cardiac surgery.
Study context
- Population
- Adults undergoing cardiac surgery9 randomized controlled trials (RCTs) reporting cardiac surgery-associated acute kidney injury (CSA-AKI)
- Participants
- 947 adults
- Comparison
- Intraoperative hemoadsorption vs standard care
- Outcome
- Cardiac surgery-associated AKI (CSA-AKI)
Methodological detailstrial sequential analysis, random-effects, subgroup and sensitivity analyses, 15 RCTs included
- Trial sequential analysis
- Random-effects
- Subgroup and sensitivity analyses
- 15 RCTs included
Pooled result
CSA-AKI
Relative risk
0.80
95% CI 0.63–1.03
P = 0.08
Hemoadsorption vs Standard care
RR 0.80 (95% CI 0.63–1.03); P = 0.08
As reported in the abstract
Further pooled results
CSA-AKI, sensitivity analyses
- Finding sensitive to model choice and to inclusion of two studies (Diab 2022 and Abou-Arab 2025)
CSA-AKI Stage 1
- No significant difference
- RR 0.72, 95% CI 0.49-1.05, P = 0.09
- I2 = 16%
CSA-AKI Stage 2
- No significant difference
- RR 0.66, 95% CI 0.30-1.43, P = 0.29
- I2 = 11%
CSA-AKI Stage 3
- No significant difference
- RR 0.43, 95% CI 0.17-1.05, P = 0.06
- I2 = 0%
RRT
- No significant difference
- RR 0.52, 95% CI 0.22-1.25, P = 0.15
- I2 = 0%
CSA-AKI by device type (subgroup)
- No significant interaction by device type
Trial sequential analyses (TSA)
- Required information size not reached
Mortality and other clinical endpoints
- Comparable between groups
IL-8 (exploratory)
- Overall reduction in IL-8
- MD −18.23, 95% CI −31.90 to −4.56, P = 0.009
- I2 = 40%
Original publication
Intraoperative hemoadsorption and cardiac surgery-associated acute kidney injury: an updated systematic review and meta-analysis with trial sequential analysis. Crit Care. Published 24 July 2026. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →