ArticlePhysiological reports2015
Renal hemodynamics, function, and oxygenation during cardiac surgery performed on cardiopulmonary bypass: a modeling study.
Article in Physiological reports, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
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Who cites it
16 citing papers in PubMed, 55 citations in OpenAlex.
- Purinergic Receptor Activation Protects Glomerular Microvasculature from Increased Mechanical Stress in Angiotensin II-Induced Hypertension: A Modeling Study.International journal of molecular sciences · 2025Article
- Risk Factors for Postoperative Acute Kidney Injury Requiring Renal Replacement Therapy in Patients Undergoing Heart Valve Surgery.Journal of clinical medicine · 2024Article
- Cardiac surgery-associated acute kidney injury in cardiopulmonary bypass: a focus on sex differences and preventive strategies.American journal of physiology. Renal physiology · 2024Review
- Cardiopulmonary bypass associated acute kidney injury: better understanding and better prevention.Renal failure · 2024Review
- Acute Kidney Injury after Cardiac Surgery: Prediction, Prevention, and Management.Anesthesiology · 2023Review
- Transfusion-Related Renal Dysfunction After Cardiac Surgery: The Role of Myeloid-Related Protein_14 in Neutrophil-Mediated Tubular Damage.JACC. Basic to translational science · 2022Article
- Comparison of renal region, cerebral and peripheral oxygenation for predicting postoperative renal impairment after CABG.Journal of clinical monitoring and computing · 2022Observational
- Sex-Specific Computational Models of Kidney Function in Patients With Diabetes.Frontiers in physiology · 2022Article
- A Computational Model of Kidney Function in a Patient with Diabetes.International journal of molecular sciences · 2021Review
- Acute kidney injury following on-pump or off-pump coronary artery bypass grafting in elderly patients: a retrospective propensity score matching analysis.Journal of cardiothoracic surgery · 2020Article
- Renal hemodynamics and oxygenation during experimental cardiopulmonary bypass in sheep under total intravenous anesthesia.American journal of physiology. Regulatory, integrative and comparative physiology · 2020Article
- The impact of mild renal dysfunction on isolated cardiopulmonary coronary artery bypass grafting: a retrospective propensity score matching analysis.Journal of cardiothoracic surgery · 2019Article
- Use of cerebral oxygen saturation and hemoglobin concentration to predict acute kidney injury after cardiac surgery.The Journal of international medical research · 2018Article
- Renal medullary and urinary oxygen tension during cardiopulmonary bypass in the rat.Mathematical medicine and biology : a journal of the IMA · 2017Article
- Article
- Lean Flow: Optimizing Cardiopulmonary Bypass Equipment and Flow for Obese Patients-A Technique Article.The journal of extra-corporeal technology · 2017Article
Corrections and comments
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Authors and funding
6 authors at 3 institutions in 2 countries.
Funding
Abstract
Acute kidney injury, a prevalent complication of cardiac surgery performed on cardiopulmonary bypass (CPB), is thought to be driven partly by hypoxic damage in the renal medulla. To determine the causes of medullary hypoxia during CPB, we modeled its impact on renal hemodynamics and function, and thus oxygen delivery and consumption in the renal medulla. The model incorporates autoregulation of renal blood flow and glomerular filtration rate and the utilization of oxygen for tubular transport. The model predicts that renal medullary oxygen delivery and consumption are reduced by a similar magnitude during the hypothermic (down to 28°C) phase of CPB. Thus, the fractional extraction of oxygen in the medulla, an index of hypoxia, is increased only by 58% from baseline. However, during the rewarming phase (up to 37°C), oxygen consumption by the medullary thick ascending limb increases 2.3-fold but medullary oxygen delivery increases only by 33%. Consequently, the fractional extraction of oxygen in the medulla is increased 2.7-fold from baseline. Thus, the renal medulla is particularly susceptible to hypoxia during the rewarming phase of CPB. Furthermore, autoregulation of both renal blood flow and glomerular filtration rate is blunted during CPB by the combined effects of hemodilution and nonpulsatile blood flow. Thus, renal hypoxia can be markedly exacerbated if arterial pressure falls below its target level of 50 mmHg. Our findings suggest that tight control of arterial pressure, and thus renal oxygen delivery, may be critical in the prevention of acute kidney injury associated with cardiac surgery performed on CPB.
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