Cardiopulmonary bypass time, inflammatory response, and acute kidney injury in cardiac surgery: a retrospective study
4 affiliations
- 1Harran University, Faculty of Health Sciences, Department of Perfusion – Şanlıurfa, Türkiye.
- 2Harran University, Research and Application Hospital, Department of Cardiovascular Surgery – Şanlıurfa, Türkiye.
- 3Harran University, Vocational School of Health Services, Dialysis Programme – Şanlıurfa, Türkiye.
- 4Ministry of Health, Ordu State Hospital, Department of Cardiovascular Surgery – Ordu, Türkiye
Abstract
SUMMARY: 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.
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BibTeX
@article{hacanlı2026cardiopulmonary,
title = {{Cardiopulmonary bypass time, inflammatory response, and acute kidney injury in cardiac surgery: a retrospective study}},
author = {Yasemin Hacanlı and Murat Ziya Bağiş and Mahmut Padak and Ömer Göç and Kadir Egi and Mehmet Burak Coşkun},
journal = {Revista da Associacao Medica Brasileira (1992)},
year = {2026},
month = oct,
doi = {10.1590/1806-9282.20260819},
url = {https://europepmc.org/article/PMC/PMC13722090},
note = {CC BY},
}
RIS
TY - JOUR
TI - Cardiopulmonary bypass time, inflammatory response, and acute kidney injury in cardiac surgery: a retrospective study
AU - Yasemin Hacanlı
AU - Murat Ziya Bağiş
AU - Mahmut Padak
AU - Ömer Göç
AU - Kadir Egi
AU - Mehmet Burak Coşkun
PY - 2026
DA - 2026/10/30
JO - Revista da Associacao Medica Brasileira (1992)
DO - 10.1590/1806-9282.20260819
UR - https://europepmc.org/article/PMC/PMC13722090
AB - SUMMARY: 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.
SN - 0104-4230
SN - 1806-9282
ER -