2026/02/01 by Sambhavi Sneha Kumar, Ujjawal Kumar, Jayenthan Karunanantham +2 · 1 voice
Medicine · #Acute Kidney Injury Research #Trauma, Hemostasis, Coagulopathy, Resuscitation #Erythropoietin and Anemia Treatment
paper · doi:10.1016/j.jcrc.2026.155474
openalex publication_date 2026/02/01 · openalex created_date 2026/02/03 · openalex updated_date 2026/07/27
To evaluate the clinical impact of cardiac surgery-associated acute kidney injury requiring continuous venovenous haemofiltration by assessing its impact on short- and long-term outcomes. Data for all adult cardiac surgeries performed between 2015 and 2024 were retrieved from our institutional database. 1:2 propensity-score matching of patients requiring postoperative haemofiltration and those not requiring haemofiltration was performed based on the EuroSCORE II covariates. In-hospital outcomes (mortality, postoperative complications, postoperative hospitalisation duration) and long-term survival were evaluated. After excluding patients requiring renal replacement therapy preoperatively, 16,681 patients were included. Propensity matching yielded Group H (postoperative haemofiltration, n = 510) and Group C (controls, n = 1020). Groups had generally similar demographics and preoperative clinical characteristics. Group H exhibited worse in-hospital outcomes compared to Group C. Hospital mortality was significantly higher in Group H (23.1% vs 6.2%, p < 0.001), with higher mortality up to five years and poorer long-term survival (HR =1.81 (95% CI: 1.50–2.18), p < 0.001). Conditional survival analyses demonstrated that among patients who survived past hospital discharge, long-term survival was comparable between groups (HR 1.23, 95% CI 0.95–1.58, p = 0.115). Postoperative AKI requiring haemofiltration is associated with poor outcomes following cardiac surgery. However, in patients surviving the acute postoperative phase, there was no significant difference in long-term survival compared to those who did not require haemofiltration. These findings underscore the importance of early recognition and management of acute kidney injury after cardiac surgery whilst offering a more nuanced understanding of long-term prognosis. • Acute kidney injury (AKI) is a major source of morbidity and mortality in cardiac surgical patients. • AKI requiring CVVH is associated with poorer outcomes in the initial postoperative period following cardiac surgery. • Patients requiring CVVH who survive to discharge from hospital demonstrate comparable long-term survival with matched controls. • Early identification and management of postoperative AKI represent important areas for improvement of clinical outcomes.