Kidney on Call

Incidence, Risk Factors and Outcomes of Postoperative Acute Kidney Injury Requiring Dialysis After Cardiac Surgery: A Retrospective Study from the National Heart Institute of Malaysia

This retrospective Malaysian cohort study examined 6,779 adult cardiac surgery patients and found that 4.5% developed postoperative acute kidney injury requiring dialysis. Risk was higher in patients with chronic kidney disease, urgent surgery, diabetes, reoperation, and longer ICU stay. Dialysis-requiring AKI was linked to sharply increased mortality, especially among patients without baseline CKD, highlighting the need for earlier renal risk stratification and kidney-protective perioperative care.

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Hemolysis and Kidney Injury Risk After Cardiac Surgery

Hemolysis and Acute Kidney Injury Following Cardiac Surgery With Cardiopulmonary Bypass in Patients With Preexisting Renal Dysfunction

This study examines whether hemolysis, measured by cell-free hemoglobin (CFHb), predicts acute kidney injury (AKI) after cardiac surgery in patients with preexisting renal dysfunction. Among 89 patients, 21% developed AKI. Although hemolysis and endothelial damage increased postoperatively, CFHb did not independently predict AKI or improve predictive models, suggesting limited clinical utility as a biomarker.

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AI-Driven Kidney Risk Prediction During Cardiac Surgery

Predicting Kidney Injury After Cardiac Surgery With Cardiopulmonary Bypass Using Machine Learning

This study evaluates a machine learning (ML) model using electronic health record (EHR) data to predict acute kidney injury (AKI) after cardiac surgery. In 130 patients, the AI achieved strong predictive performance (AUROC 0.79 for AKI, 0.83 for 30-day kidney disease). The model enables early, automated risk stratification, offering a practical tool for proactive perioperative management and improved patient outcomes.

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Global Cardiac Surgery Team Comparing HES vs Albumin

Comparison of 6% Hydroxyethyl Starch 130/0.4 vs 5% Albumin in Cardiopulmonary Bypass for Cardiac Surgery

This meta-analysis of 12 studies (908 patients) compares 6% hydroxyethyl starch (HES 130/0.4) and 5% albumin in cardiac surgery with cardiopulmonary bypass. Results show no significant differences in blood loss, transfusion needs, ICU stay, or mortality. However, HES is associated with a significantly higher risk of acute kidney injury, raising concerns about its renal safety despite similar overall efficacy.

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Monitoring Venous Pressure After Cardiac Surgery: Protecting Kidney Function

Exploring the Role of Central Venous Pressure in Cardiac Surgery-Associated Acute Kidney Injury: A Comprehensive Scoping Review

This scoping review evaluates the association between central venous pressure (CVP) and acute kidney injury (AKI) following cardiac surgery, particularly CABG. Across 16 studies, elevated CVP consistently correlated with higher AKI risk, especially when combined with low mean arterial pressure. However, variability in CVP thresholds and study designs limits clinical standardization. The findings highlight CVP as a potential perioperative marker requiring further validation.

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Kidneys at Risk During Cardiac Bypass Surgery

Risk Factors for Acute Kidney Injury After Coronary Artery Bypass Graft Surgery: A Systematic Review and Meta-Analysis

Acute kidney injury (AKI) is a serious complication after coronary artery bypass graft (CABG) surgery. This systematic review and meta-analysis analyzed 17 observational studies including 33,809 patients to identify key predictors of AKI. Significant risk factors included advanced age, prolonged cardiopulmonary bypass duration, diabetes, intra-aortic balloon pump use, and red blood cell transfusion. Recognizing these risks may help clinicians improve perioperative management and reduce kidney complications after cardiac surgery.

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Peripheral Versus Central Cannulation for Venoarterial Extracorporeal Membrane Oxygenation

Peripheral Versus Central Cannulation for Venoarterial Extracorporeal Membrane Oxygenation (VA-ECMO): A Meta-Analysis of Bleeding and Vascular Complications

This meta-analysis of 15 studies (2,913 patients) compares peripheral and central cannulation strategies for VA-ECMO in refractory cardiogenic shock. Peripheral access significantly reduced major bleeding risk but increased limb ischemia. No meaningful differences were observed in infection, renal replacement therapy, or stroke. Findings support individualized cannulation decisions balancing bleeding risk against vascular complications.

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Comparison of 6% Hydroxyethyl Starch 130/0.4 vs 5% Albumin

Comparison of 6% Hydroxyethyl Starch 130/0.4 vs 5% Albumin in Cardiopulmonary Bypass for Cardiac Surgery

This meta-analysis evaluated 12 randomized trials (908 patients) comparing 6% hydroxyethyl starch (HES) 130/0.4 with 5% albumin during cardiopulmonary bypass in cardiac surgery. Most outcomes—including blood loss, transfusion rates, ICU stay, hospital stay, and mortality—were similar between groups. However, HES use was associated with a significantly higher risk of acute kidney injury, highlighting renal safety concerns despite comparable hemodynamic efficacy.

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Vasoplegic Syndrome in Cardiac Surgery

Vasoplegic Syndrome in Cardiac Surgery: Bridging Therapeutic Gaps with Best Practices and Future Research

This article explores vasoplegic syndrome (VS), a serious complication following cardiac surgery involving cardiopulmonary bypass. It discusses inconsistent definitions, risk factors, and treatment strategies. Methylene blue emerges as a promising therapy due to its ability to counteract the nitric oxide-cGMP pathway. The authors advocate for standardized definitions, early intervention, and large-scale trials to validate therapeutic protocols.

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Intraoperative Renal Near-Infrared Spectroscopy

Intraoperative Renal Near-Infrared Spectroscopy Monitoring as a Predictor of Renal Outcomes in Cardiac Surgery

This study assessed whether intraoperative renal near-infrared spectroscopy (NIRS) could predict acute renal failure (ARF) in 357 cardiac surgery patients. It found that longer durations of reduced renal oxygenation (rSO₂) below 80%, 70%, and 60% thresholds were significantly associated with ARF development. NIRS monitoring showed high sensitivity and specificity, indicating its potential for early detection and intervention during surgery.

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