{
  "abstract": "Background and goal of study\n\nWhether preoperative natremia levels may play a role in the development of acute kidney injury (AKI) after cardiac surgery is uncertain. We conducted a cohort study to evaluate the influence of preoperative natremia on AKI in high-risk patients undergoing cardiac surgery.Materials and methods\n\nThis multicenter prospective cohort study involved 14 British and Spanish hospitals, each under local ethics committee approval. The study population comprised all consecutive patients aged 18 years or older, with a Cleveland Clinic score ≥ 4, undergoing cardiac surgery from July to December 2017. The resultant 241 consecutive patients were classified according to tertiles of preoperative natremia levels (< 139, > 139-141, and > 141 mmol/L).Results and discussion\n\nThe AKIN criteria were used to define AKI. Multivariable logistic regression was used to estimate the adjusted association between preoperative natremia and AKI. A potential link was observed between sodium levels ≤ 139 mmol/L and an increased risk of moderate-to-severe AKI relative to levels above 141 mmol/L (OR 2.01, 95% CI 1.02-3.95, p = 0.03), after multivariable adjustment for age and preoperative serum creatinine. No significant associations were observed between sodium levels and RRT or in-hospital mortality. Conclusions The results from this cohort of high-risk cardiac surgery patients lend tentative support to the hypothesis that preoperative natremia levels ≤ 139 mmol/L might be linked to a higher risk of moderate-to-severe AKI compared with levels above 141 mmol/L. These findings warrant further evaluation in a larger cohort.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Nephrology, Clínica Universidad de Navarra, Pamplona, Spain.",
    "Department of Anesthesiology & Critical Care Medicine, Clínica Universidad de Navarra, Pamplona, Spain.",
    "Department of Anesthesiology & Perioperative Medicine, Hospital Universitario Ramón y Cajal, Madrid, Spain.",
    "Department of Anesthesiology & Perioperative Medicine, Hospital Clínico Universitario de Valladolid, Valladolid, Spain.",
    "Department of Anaesthesia & Perioperative Medicine, Barts Heart Centre, St Bartholomew's Hospital, London, UK.",
    "Research Support Service, Central Clinical Trials Unit, Clínica Universidad de Navarra, Pamplona, Spain.",
    "Department of Anesthesiology & Critical Care Medicine, Clínica Universidad de Navarra, Pamplona, Spain. gecharri@unav.es.",
    "Department of Anesthesiology & Critical Care Medicine, Clínica Universidad de Navarra, Pamplona, Spain. mvives@unav.es.",
    "Instituto de Investigación Sanitaria de Navarra, IdiSNA, Pamplona, Spain. mvives@unav.es."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 10,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Jose Maria Mora"
    },
    {
      "affs": [
        1
      ],
      "name": "Pablo Montero-López"
    },
    {
      "affs": [
        2
      ],
      "name": "Angel Candela"
    },
    {
      "affs": [
        3
      ],
      "name": "Esther Gómez"
    },
    {
      "affs": [
        4
      ],
      "name": "David Nagore"
    },
    {
      "affs": [
        5
      ],
      "name": "Jorge M Núñez-Córdoba"
    },
    {
      "affs": [
        6
      ],
      "name": "Gemma Echarri"
    },
    {
      "affs": [
        1
      ],
      "name": "Raquel Callejas"
    },
    {
      "affs": [
        7,
        8
      ],
      "name": "Marc Vives",
      "orcid": "0000-0001-6955-8051"
    },
    {
      "name": "on behalf of the Spanish Perioperative Cardiac Surgery Research Group"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/6p7hnv0103tnf.bib",
  "cited_by": 0,
  "doi": "10.1186/s44158-026-00436-1",
  "fulltext_url": "https://europepmc.org/articles/PMC13679012",
  "id": "6p7hnv0103tnf",
  "issns": [
    "2731-3786"
  ],
  "landing_url": "https://europepmc.org/article/MED/42894242",
  "language": "eng",
  "licence": "CC-BY-NC-ND",
  "licence_label": "CC BY-NC-ND",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "lcc",
      "RC86-88.9"
    ],
    [
      "lcc",
      "RD78.3-87.3"
    ],
    [
      "openalex",
      "2727|Acute Kidney Injury Research"
    ]
  ],
  "openalex": "W7170172259",
  "pdf_url": "https://europepmc.org/articles/PMC13679012?pdf=render",
  "pmcid": "PMC13679012",
  "pmid": "42894242",
  "published": "2026-07-01",
  "publisher": "BMC",
  "ris": "https://research.draconitic.com/paper/6p7hnv0103tnf.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:19:42Z",
      "native_id": "MED:42894242",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42894242"
    },
    {
      "first_seen": "2026-10-30T13:46:32Z",
      "native_id": "3e5958f92e744bf389b736fd701f1c44",
      "source": "doaj",
      "url": "https://doi.org/10.1186/s44158-026-00436-1"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "lcc:RD78.3-87.3",
      "subfield": "surgery"
    }
  ],
  "title": "Preoperative natremia and AKI after cardiac surgery: an international multicenter prospective cohort study.",
  "title_text": "Preoperative natremia and AKI after cardiac surgery: an international multicenter prospective cohort study.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T13:46:32Z",
  "url": "https://research.draconitic.com/paper/6p7hnv0103tnf",
  "venue": "Journal of anesthesia, analgesia and critical care",
  "versions": []
}