Cardiopulmonary Bypass Blood Flow Rates and Major Adverse Kidney Events in Cardiac Surgery: A Propensity...

Area of Science:

• Nephrology
• Cardiology
• Cardiac Surgery

Background:

• Acute kidney injury following cardiac surgery is a significant complication, increasing patient morbidity and mortality.
• Understanding factors influencing postoperative kidney outcomes is crucial for improving patient care.

Purpose of the Study:

• To investigate the association between cardiopulmonary bypass blood flow rate (CPB-BFR) and major adverse kidney events (MAKEs) at 30 days post-cardiac surgery.

Main Methods:

• A retrospective, single-center observational study included 533 adult patients undergoing cardiac surgery with CPB duration ≥90 minutes.
• Patients were stratified into low CPB-BFR (>2.2 L/min/m²) and high CPB-BFR (>2.4 L/min/m²) groups.
• MAKE was defined as a composite of death, renal replacement therapy, or persistent renal dysfunction at 30 days.

Main Results:

• The high CPB-BFR group showed a significant reduction in MAKE at 30 days (3% vs. 8%; OR, 0.779; p < 0.001).
• This reduction was primarily driven by lower 30-day mortality (1% vs. 5%; OR, 0.697; p = 0.001) and decreased rates of renal replacement therapy (1% vs. 4%; OR, 0.739; p = 0.016) in the high CPB-BFR group.

Conclusions:

• Higher CPB-BFR in cardiac surgery patients is associated with a significant decrease in 30-day MAKE.
• Optimizing CPB-BFR may be a strategy to mitigate adverse kidney outcomes and reduce mortality after cardiac surgery.