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Association between 20% Albumin Use and Acute Kidney Injury in Major Abdominal Surgery with Transfusion
Hye Jin Kim1, Hyun Joo Kim1, Jin Ha Park1
1Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Republic of Korea.
International Journal of Molecular Sciences
|February 11, 2023
Summary
Intraoperative albumin administration did not increase the risk of acute kidney injury (AKI) in patients receiving red blood cell (RBC) transfusions during major abdominal surgery. Albumin did not impact mortality but was linked to longer hospital stays.
Area of Science:
- Nephrology
- Anesthesiology
- Surgical Critical Care
Background:
- Red blood cell (RBC) transfusions and albumin administration are common in major abdominal surgery.
- Both interventions can potentially impact kidney function and patient outcomes.
- Understanding the specific effects of intraoperative albumin is crucial for patient management.
Purpose of the Study:
- To evaluate the association between intraoperative 20% albumin administration and acute kidney injury (AKI).
- To assess the impact of albumin on hospitalization duration and 30-day mortality in patients undergoing major abdominal surgery with RBC transfusion.
Main Methods:
- Retrospective study of 2408 patients undergoing major abdominal surgery with RBC transfusion.
- Comparison between an albumin group (n=842) and a no-albumin group (n=1566).
- Statistical analyses included inverse probability of treatment weighting (IPTW), propensity score matching (PSM), and PS covariate adjustment.
Main Results:
- Unadjusted analysis showed increased AKI risk, prolonged hospitalization, and higher 30-day mortality with albumin.
- After IPTW, PSM, and PS covariate adjustment, no significant association was found between albumin administration and AKI.
- Albumin administration was associated with prolonged hospitalization but not with 30-day mortality in adjusted analyses.
Conclusions:
- Intraoperative 20% albumin administration appears safe regarding AKI risk in patients undergoing major abdominal surgery with RBC transfusion.
- Hyper-oncotic albumin may be safely used in at-risk patients without increasing the incidence of AKI.
- Further research may explore the mechanisms behind prolonged hospitalization associated with albumin use.
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