Evidence map›Paper›PMID 34837387›Full record

SynthesisClinical cardiology2021

Ultrafiltration and cardiopulmonary bypass associated acute kidney injury: A systematic review and meta-analysis.

Omneya A Kandil, Karam R Motawea, Edward Darling, Jeffrey B Riley, Jaffer Shah, Mohamed Abdalla Mohamed Elashhat, Bruce Searles, Hani Aiash

Open access · goldAbstract readMeta-AnalysisSystematic Review
In one paragraph

Synthesis in Clinical cardiology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
13citing papers in PubMed, 2 pooled it
2.9field-weighted citation impact, top 8% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

13 citing papers in PubMed, 2 syntheses or guidelines pooled it, 26 citations in OpenAlex.

  1. Guideline
  2. Pooled it
  3. Trial
  4. 2024 EACTS/EACTAIC Guidelines on patient blood management in adult cardiac surgery in collaboration with EBCP.European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery · 2025
    Article
  5. Article
  6. 2024 EACTS/EACTAIC/EBCP Guidelines on cardiopulmonary bypass in adult cardiac surgery.Interdisciplinary cardiovascular and thoracic surgery · 2025
    Article
  7. 2024 EACTS/EACTAIC/EBCP Guidelines on cardiopulmonary bypass in adult cardiac surgery.European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery · 2025
    Article
  8. Article
  9. Review
  10. Review
  11. Review
  12. Review
  13. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 5 institutions in 3 countries.

Omneya A KandilFaculty of Medicine, Alexandria University, Alexandria, Egypt.
Karam R MotaweaFaculty of Medicine, Alexandria University, Alexandria, Egypt.
Edward DarlingDepartment of Cardiovascular Perfusion, State University of New York Upstate Medical University, Syracuse, New York, USA.
Jeffrey B RileyDepartment of Cardiovascular Perfusion, State University of New York Upstate Medical University, Syracuse, New York, USA.
Jaffer ShahMedical Research Center, Kateb University, Kabul, Afghanistan.ORCID http://orcid.org/0000-0002-8961-218X
Mohamed Abdalla Mohamed ElashhatAswan Heart Center (Magdy Yacoub Foundation), Aswan Governorate, Aswan, Egypt.
Bruce SearlesDepartment of Cardiovascular Perfusion, State University of New York Upstate Medical University, Syracuse, New York, USA.
Hani AiashDepartment of Cardiovascular Perfusion, State University of New York Upstate Medical University, Syracuse, New York, USA.
SUNY Upstate Medical University · USAlexandria University · EGAswan University · EGKabul Medical University · AFSuez Canal University · EG

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundCardiopulmonary bypass is known to raise the risk of acute kidney injury (AKI). Previous studies have identified numerous risk factors of cardiopulmonary bypass including the possible impact of perioperative ultrafiltration. However, the association between ultrafiltration (UF) and AKI remains conflicting. Thus, we conducted a meta-analysis to further examine the relationship between UF and AKI. HYPOTHESIS: Ultrafiltration during cardiac surgery increases the risk of developping Acute kidney Injury.

methodsWe searched PubMed, Web of Science, EBSCO, and SCOPUS through July 2021. The RevMan (version 5.4) software was used to calculate the pooled risk ratios (RRs) and mean differences along with their associated confidence intervals (95% CI).

resultsWe identified 12 studies with a total of 8005 patients. There was no statistically significant difference in the incidence of AKI between the group who underwent UF and the control group who did not (RR = 0.90, 95% CI = 0.64-1). Subgroup analysis on patients with previous renal insufficiency also yielded nonsignificant difference (RR = 0.84, 95% CI = 0.53 -1.33, p = .47). Subgroup analysis based on volume of ultrafiltrate removed (> or <2900 ml) was not significant and did not increase the AKI risk as predicted (RR = 0.82, 95% CI = 0.63 -1.07, p  = .15). We also did subgroup analysis according to the type of UF and again no significant difference in AKI incidence between UF groups and controls was observed in either the conventional ultrafiltration (CUF), modified ultrafiltration (MUF), zero-balanced ultrafiltration (ZBUF), or combined MUF and CUF subgroups.

conclusionUF in cardiac surgery is not associated with increased AKI incidence and may be safely used even in baseline chronic injury patients.

Indexed as

Acute Kidney InjuryCardiac Surgical ProceduresCardiopulmonary BypassHumansRisk FactorsUltrafiltrationacute kidney injurycardiac surgerycardiopulmonary bypassfluid managementultrafiltration

Identifiers

PMID34837387
PMCPMC8715396
OpenAlexW3217540423

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.