ArticlePloS one2017
Perioperative hemoglobin area under the curve is an independent predictor of renal failure after cardiac surgery. Results from a Spanish multicenter retrospective cohort study.
Article in PloS one, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.
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Who cites it
10 citing papers in PubMed, 1 synthesis or guideline pooled it, 25 citations in OpenAlex.
- Effects of restrictive red blood cell transfusion on the prognoses of adult patients undergoing cardiac surgery: a meta-analysis of randomized controlled trials.Critical care (London, England) · 2018Pooled it
- Effect of a Topical Thrombin-Carboxymethyl Starch Hemostatic Agent on Perioperative Hemoglobin Course: A Propensity Score-Matched Study.Medicina (Kaunas, Lithuania) · 2026Observational
- Comparable renal effects of histidine-tryptophan-ketoglutarate and DelNido cardioplegia in a porcine model of cardiac arrest.Renal failure · 2025Article
- Article
- Complete blood count in acute kidney injury prediction: a narrative review.Annals of intensive care · 2019Review
- Acute kidney injury after cardiac surgery: prevalence, impact and management challenges.International journal of nephrology and renovascular disease · 2019Article
- Biomarkers of Acute Kidney Injury after Cardiac Surgery: A Narrative Review.BioMed research international · 2019Review
- Predictors of Extended Length of Hospital Stay Following Surgical Repair of Congenital Heart Diseases.Pediatric cardiology · 2018Article
- Red blood cell antibody-induced anemia causes differential degrees of tissue hypoxia in kidney and brain.American journal of physiology. Regulatory, integrative and comparative physiology · 2018Article
- Frequency of Renal Dysfunction and its effects on outcomes after open heart surgery.Pakistan journal of medical sciencesArticle
Corrections and comments
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Authors and funding
8 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Perioperative anemia is an important risk factor for cardiac surgery-associated acute kidney injury (CSA-AKI). Nonetheless, the severity of the anemia and the time in the perioperative period in which the hemoglobin level should be considered as a risk factor is conflicting. The present study introduces the concept of perioperative hemoglobin area under the curve (pHb-AUC) as a surrogate marker of the evolution of perioperative hemoglobin concentration. Through a retrospective analysis of prospectively collected data, we assessed this new variable as a risk factor for the development of acute kidney injury after cardiac surgery in 966 adult patients who underwent cardiac surgery with cardiopulmonary bypass, at twenty-three academic hospitals in Spain. Exclusion criteria were patients on renal replacement therapy, who needed a reoperation because of bleeding and/or with missing perioperative hemoglobin or creatinine values. Using a multivariate regression analysis, we found that a pHb-AUC <19 g/dL was an independent risk factor for CSA-AKI even after adjustment for intraoperative red blood cell transfusion (OR 1.41, p <0.05). It was also associated with mortality (OR 2.48, p <0.01) and prolonged hospital length of stay (4.67 ± 0.99 days, p <0.001).
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