Prediction of Acute Kidney Injury After Cardiac Surgery With Cardiopulmonary Bypass

NCT07343830 | Completed

• 2 other identifiers: AKI-CPB-RETRO-20252026/1
• Study Type: observational
• Target: 455
• Locations: 1 country
• Sites: 1

Brief Summary

Acute kidney injury (AKI) is a common and serious complication following cardiac surgery performed under cardiopulmonary bypass and is associated with increased morbidity, mortality, and prolonged hospital stay. Despite advances in perioperative management, the ability to accurately predict postoperative AKI remains limited. 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.

Conditions

Acute Kidney Injury; Cardiac Surgery; Cardiopulmonary Bypass Surgery; Cardiac Surgery Associated - Acute Kidney Injury

Keywords

Acute kidney injury; Cardiac surgery; Cardiopulmonary bypass; Inflammatory markers; Neutrophil to lymphocyte ratio; Systemic immune inflammation index; C-reactive protein albumin ratio; Renal perfusion; Perfusion stress; KDIGO

Outcome Measures

Primary Outcomes (1)

• Postoperative Acute Kidney Injury

  Development of acute kidney injury within 72 hours after cardiac surgery performed under cardiopulmonary bypass. Acute kidney injury will be defined according to the KDIGO serum creatinine criteria, based on an increase in serum creatinine of ≥0.3 mg/dL within 48 hours or ≥1.5 times baseline within 7 days. Urine output criteria will not be evaluated due to the retrospective nature of the study.

  Within 72 hours after cardiac surgery

Secondary Outcomes (2)

• Severity of postoperative AKI (KDIGO stage)

  Within 72 hours after cardiac surgery (postoperative days 0-3); assessed using the highest serum creatinine value measured every 12 hours (6 measurements)

• In-Hospital Mortality

  From the date of cardiac surgery through hospital discharge (index hospitalization), assessed at hospital discharge (up to 90 days)

Study Arms (2)

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 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.

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

Adult patients undergoing cardiac surgery with cardiopulmonary bypass at a single tertiary care center.

You may qualify if:

• Adults aged 18 years or older
• Patients who underwent cardiac surgery under cardiopulmonary bypass
• Coronary artery bypass grafting, valve surgery, or combined cardiac surgery
• Elective or emergency procedures

You may not qualify if:

• Preoperative end-stage renal disease requiring dialysis
• Preoperative serum creatinine level greater than 4.0 mg/dL
• Off-pump cardiac surgery
• Missing preoperative or postoperative serum creatinine data

Sponsors & Collaborators

• Ataturk University: lead

Study Sites (1)

Ataturk University

Erzurum, 25240, Turkey (Türkiye)

Location

Related Publications (8)

• 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.

  PMID: 22890468 BACKGROUND

• 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.

  PMID: 32577578 BACKGROUND

• 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.

  PMID: 38937949 BACKGROUND

• 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.

  PMID: 32821341 BACKGROUND

• 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.

  PMID: 22186469 BACKGROUND

• 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.

  PMID: 30365961 BACKGROUND

• 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.

  PMID: 26025079 BACKGROUND

• 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.

  PMID: 19398670 BACKGROUND

MeSH Terms

Conditions

Acute Kidney Injury

Condition Hierarchy (Ancestors)

Renal Insufficiency; Kidney Diseases; Urologic Diseases; Female Urogenital Diseases; Female Urogenital Diseases and Pregnancy Complications; Urogenital Diseases; Male Urogenital Diseases

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: RETROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal Investigator

Study Record Dates

• First Submitted: January 6, 2026
• First Posted: January 15, 2026
• Study Start: January 30, 2026
• Primary Completion: February 2, 2026
• Study Completion: February 2, 2026
• Last Updated: February 4, 2026

Record last verified: 2026-02

Data Sharing

• IPD Sharing: Will not share

Locations

TU (1)