Prediction of Acute Kidney Injury After Cardiac Surgery With Cardiopulmonary Bypass
NCT ID: NCT07343830
Last Updated: 2026-01-15
Study Results
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Basic Information
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NOT_YET_RECRUITING
500 participants
OBSERVATIONAL
2026-01-15
2026-02-15
Brief Summary
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Recent evidence suggests that preoperative inflammatory markers derived from routine laboratory tests, as well as indicators of intraoperative perfusion stress, may play an important role in the development of AKI. However, data evaluating these factors together in patients undergoing cardiac surgery with cardiopulmonary bypass are limited.
This retrospective observational cohort study aims to investigate the association between preoperative renal function, inflammatory indices, and intraoperative perfusion-related parameters with the development of postoperative AKI. Acute kidney injury will be defined according to the KDIGO serum creatinine criteria within the first 72 hours after surgery. The findings of this study may help identify patients at increased risk for AKI and contribute to improved perioperative risk stratification in cardiac surgery.
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Detailed Description
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In recent years, easily accessible inflammatory indices derived from routine hematological and biochemical parameters, such as the neutrophil-to-lymphocyte ratio, systemic immune-inflammation index, and C-reactive protein to albumin ratio, have been proposed as potential predictors of postoperative complications, including AKI. In addition, intraoperative parameters reflecting perfusion stress, such as cardiopulmonary bypass duration, arterial lactate levels, and acid-base disturbances, may further contribute to renal injury. However, studies evaluating these factors together in the setting of cardiac surgery with CPB are limited.
This single-center, retrospective observational cohort study will include adult patients who underwent cardiac surgery under cardiopulmonary bypass. Demographic data, comorbidities, preoperative laboratory parameters, echocardiographic findings, and intraoperative CPB-related variables will be collected retrospectively from institutional medical records. Acute kidney injury will be defined and staged according to the KDIGO serum creatinine criteria within 48-72 hours after surgery. Urine output criteria will not be evaluated due to limitations inherent to retrospective data collection.
The primary objective of the study is to identify independent predictors of postoperative AKI by assessing the combined effects of preoperative renal function, inflammatory markers, and intraoperative perfusion stress parameters. Secondary objectives include evaluation of AKI severity and in-hospital mortality. Multivariable logistic regression and receiver operating characteristic analyses will be used to determine the predictive value of selected parameters.
By improving understanding of the factors associated with postoperative AKI, this study aims to support better perioperative risk stratification and inform future prospective investigations in patients undergoing cardiac surgery with cardiopulmonary bypass.
Conditions
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Study Design
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COHORT
RETROSPECTIVE
Study Groups
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Postoperative AKI
Patients who developed acute kidney injury within 72 hours after cardiac surgery under cardiopulmonary bypass, defined according to the KDIGO serum creatinine criteria.
No interventions assigned to this group
No Postoperative AKI
Patients who did not develop acute kidney injury within 72 hours after cardiac surgery under cardiopulmonary bypass according to the KDIGO serum creatinine criteria.
No interventions assigned to this group
Eligibility Criteria
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Inclusion Criteria
* Patients who underwent cardiac surgery under cardiopulmonary bypass
* Coronary artery bypass grafting, valve surgery, or combined cardiac surgery
* Elective or emergency procedures
Exclusion Criteria
* Preoperative serum creatinine level greater than 4.0 mg/dL
* Off-pump cardiac surgery
* Missing preoperative or postoperative serum creatinine data
18 Years
ALL
No
Sponsors
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Ataturk University
OTHER
Responsible Party
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Mehmet Akif Yilmaz
Principal Investigator
Locations
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Ataturk University
Erzurum, , Turkey (Türkiye)
Countries
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Central Contacts
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Facility Contacts
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References
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Khwaja A. KDIGO clinical practice guidelines for acute kidney injury. Nephron Clin Pract. 2012;120(4):c179-84. doi: 10.1159/000339789. Epub 2012 Aug 7. No abstract available.
Lee JW, Sharma AR, Lee SS, Chun WJ, Kim HS. The C-reactive protein to albumin ratio predicts postoperative complication in patients who undergo gastrectomy for gastric cancer. Heliyon. 2020 Jun 15;6(6):e04220. doi: 10.1016/j.heliyon.2020.e04220. eCollection 2020 Jun.
Sun J, Qi Y, Wang W, Meng P, Han C, Chen B. Systemic Immune-Inflammation Index (SII) as a Predictor of Short-Term Mortality Risk in Sepsis-Associated Acute Kidney Injury: A Retrospective Cohort Study. Med Sci Monit. 2024 Jun 28;30:e943414. doi: 10.12659/MSM.943414.
Bi JB, Zhang J, Ren YF, Du ZQ, Wu Z, Lv Y, Wu RQ. Neutrophil-to-lymphocyte ratio predicts acute kidney injury occurrence after gastrointestinal and hepatobiliary surgery. World J Gastrointest Surg. 2020 Jul 27;12(7):326-335. doi: 10.4240/wjgs.v12.i7.326.
Huen SC, Parikh CR. Predicting acute kidney injury after cardiac surgery: a systematic review. Ann Thorac Surg. 2012 Jan;93(1):337-47. doi: 10.1016/j.athoracsur.2011.09.010.
Lannemyr L, Bragadottir G, Hjarpe A, Redfors B, Ricksten SE. Impact of Cardiopulmonary Bypass Flow on Renal Oxygenation in Patients Undergoing Cardiac Operations. Ann Thorac Surg. 2019 Feb;107(2):505-511. doi: 10.1016/j.athoracsur.2018.08.085. Epub 2018 Oct 23.
Lagny MG, Jouret F, Koch JN, Blaffart F, Donneau AF, Albert A, Roediger L, Krzesinski JM, Defraigne JO. Incidence and outcomes of acute kidney injury after cardiac surgery using either criteria of the RIFLE classification. BMC Nephrol. 2015 May 30;16:76. doi: 10.1186/s12882-015-0066-9.
Hobson CE, Yavas S, Segal MS, Schold JD, Tribble CG, Layon AJ, Bihorac A. Acute kidney injury is associated with increased long-term mortality after cardiothoracic surgery. Circulation. 2009 May 12;119(18):2444-53. doi: 10.1161/CIRCULATIONAHA.108.800011. Epub 2009 Apr 27.
Other Identifiers
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2026/1
Identifier Type: OTHER
Identifier Source: secondary_id
AKI-CPB-RETRO-2025
Identifier Type: -
Identifier Source: org_study_id
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