Cardiopulmonary bypass time, inflammatory response, and acute kidney injury in cardiac surgery: a retrospective study
Year: 2026
Type: article
Study design: Observational Study
Abstract: OBJECTIVE: The aim of this study was to evaluate changes in inflammatory markers after cardiac surgery with cardiopulmonary bypass and assess the discriminatory ability of aortic cross-clamp time for postoperative acute kidney injury. METHODS: This retrospective single-center study included 109 patients undergoing cardiopulmonary bypass-assisted cardiac surgery between January 2024 and March 2025. Preoperative and postoperative (30-36 h) creatinine, urea, albumin, C-reactive protein, neutrophil, and lymphocyte levels were evaluated. Acute kidney injury was defined using the serum creatinine component of KDIGO criteria. C-reactive protein/albumin ratio, C-reactive protein/lymphocyte ratio, neutrophil/lymphocyte ratio, and albumin×lymphocyte/C-reactive protein (CALLY) were calculated. Given the limited number of acute kidney injury cases, analyses were exploratory. Aortic cross-clamp time was assessed by receiver operating characteristic analysis. RESULTS: Postoperative neutrophil, lymphocyte, and albumin levels differed significantly from preoperative values (all false discovery rate-corrected p<0.001). C-reactive protein, C-reactive protein/albumin ratio, C-reactive protein/lymphocyte ratio, neutrophil/lymphocyte ratio, and CALLY levels increased significantly (all false discovery rate-corrected p<0.001). Acute kidney injury developed in 15 patients and was more common among non-survivors (10.1 vs. 50.0%; p=0.006; false discovery rate-corrected p=0.022). Postoperative creatinine levels were higher in non-survivors (false discovery rate-corrected p=0.011). Aortic cross-clamp time showed limited discrimination for Acute kidney injury (area under curve=0.621). At the 52-min cutoff, sensitivity was 66.7%, and specificity was 60.2%. CONCLUSION: Cardiopulmonary bypass-associated cardiac surgery was accompanied by significant inflammatory changes. Aortic cross-clamp time showed limited discriminatory ability and should be considered an exploratory risk indicator rather than a standalone predictor of acute kidney injury.
Institution: Harran University
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7224945098