Abstract
Plasma viscosity (PV) is a key factor in microcirculatory flow resistance and capillary perfusion during hemodilution, we hypothesized a possible relationship between cardiac surgery-associated acute kidney injury (CSA-AKI) and PV. We conducted a prospective, observational, single-center study on 50 adult cardiac surgery patients with cardiopulmonary bypass (age 64 years, male sex 80%, baseline serum creatinine 1.04 mg/dL). We assessed perioperative characteristics, management, short-term outcomes, blood analysis, PV, serum creatinine, and diuresis. CSA-AKI was identified using KDIGO criteria. Data were collected at 10 time points during the first perioperative week. CSA-AKI occurred in 17 patients (34%): 12 (24%) stage 1, 1 (2%) stage 2, and 4 (8%) stage 3. Most patients (88%) developed CSA-AKI within 48 h post-surgery. Patients with CSA-AKI had higher body mass index (BMI), more frequent chronic kidney disease (CKD), and lower hemoglobin and hematocrit levels. The median baseline PV for the entire cohort was 1.50 cP on EDTA and 1.37 cP on citrate. No significant differences in PV levels were found between patients with CSA-AKI and normal kidney function, both at baseline and at the 48-h. Logistic and Cox regression analyses showed no significant relationship between PV and CSA-AKI. However, CSA-AKI was related to increased BMI, lower hemoglobin and hematocrit levels, and pre-existing CKD. The present study found no significant association between PV and CSA-AKI. Nevertheless, more research is needed to validate this finding and to investigate the role of PV in other clinical settings.
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DL, SA, LV, GS conceived the study; LV, CR, TB collected and analyzed data and edited the manuscript; LV, SA, GS analyzed data and wrote the first draft; SA, DL supervised the project. All authors contributed to the article and approved the submitted version.
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The study was conducted according to the guidelines of the Declaration of Helsinki and approved by the Institutional Review Board of Emergency Institute for Cardiovascular Disease, “Prof. dr. C. C. Iliescu”, Bucharest, Romania (registration number 22927/01.10.2018).
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Informed written consent was obtained from all subjects involved in the study for the use of routinely collected data for research purposes as part of their regular medical care in the contract of the Institutional Review Board of Emergency Institute for Cardiovascular Disease, “Prof. dr. C. C. Iliescu”, Bucharest, Romania.
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Valeanu, L., Andrei, S., Stefan, G. et al. Cardiac surgery-associated acute kidney injury and perioperative plasma viscosity: is there a relationship?. J Clin Monit Comput 37, 1553–1561 (2023). https://doi.org/10.1007/s10877-023-01065-7
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DOI: https://doi.org/10.1007/s10877-023-01065-7