Evidence map›Paper›PMID 37505258›Full record

Observational studyIntensive care medicine2023

Epidemiology of surgery associated acute kidney injury (EPIS-AKI): a prospective international observational multi-center clinical study.

Alexander Zarbock, Raphael Weiss, Felix Albert, Kristen Rutledge, John A Kellum, Rinaldo Bellomo, Evgeny Grigoryev, Angel M Candela-Toha, Z Aslı Demir, Vincent Legros and 9 more

Registry-linked trialAbstract readObservational StudyMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Intensive care medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07617675 (Perioperative Recombinant Human Brain Natriuretic Peptide for Renal Protection in Cardiac Surgery), which is not on this map. Cited by 94 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
94citing papers in PubMed, 5 pooled it
–field-weighted citation impact
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.

NCT07617675 phase4not yet recruitingnot on this mapstarted 2026, after this paper: background citation

Perioperative Recombinant Human Brain Natriuretic Peptide for Renal Protection in Cardiac Surgery: the PROTECT-CS Randomized Clinical Trial

TypeinterventionalSponsorChina National Center for Cardiovascular DiseasesRan2026 to 2029Enrolled694ConditionsAKI - Acute Kidney Injury, Cardiac Surgical Procedures, Cardiopulmonary BypassArmsRecombinant Human Brain Natriuretic Peptide (rhBNP), Normal Saline (Placebo)
3 · Its place in the literature

Who cites it

94 citing papers in PubMed, 5 syntheses or guidelines pooled it.

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34 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

19 authors.

Alexander Zarbock *Department of Anesthesiology, Intensive Care and Pain Medicine, University Hospital Münster, Albert-Schweitzer-Campus 1, Gebäude A1, 48149, Münster, Germany. zarbock@uni-muenster.de.ORCID 0000-0002-2124-1714
Raphael Weiss *Department of Anesthesiology, Intensive Care and Pain Medicine, University Hospital Münster, Albert-Schweitzer-Campus 1, Gebäude A1, 48149, Münster, Germany.
Felix AlbertInstitute of Biostatistics and Clinical Research, University of Münster, Münster, Germany.
Kristen RutledgeDepartment of Anesthesiology and Perioperative Medicine, University of Alabama, Birmingham, USA.
John A KellumCenter for Critical Care Nephrology, Department of Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
Rinaldo BellomoDepartment of Critical Care, The University of Melbourne, Melbourne, Australia.
Evgeny GrigoryevDepartment of Anesthesiology, Kemerovo Cardiology Centre, Kemerovo, Russia.
Angel M Candela-TohaDepartment of Anesthesiology, University Hospital Ramón y Cajal, Madrid, Spain.
Z Aslı DemirDepartment of Anesthesiology, Ankara Bilkent City Hospital, Health Science University, Ankara, Turkey.
Vincent LegrosDepartment of Anesthesiology and Critical Care, Hôpital Maison Blanche, University Hospital, 51100, Reims, France.
Peter RosenbergerDepartment of Anesthesiology and Intensive Care, University Hospital Tübingen, Tübingen, Germany.
Patricia Galán MenéndezDepartment of Anesthesiology and Intensive Care, University Hospital Vall d'Hebron, Barcelona, Spain.
Mercedes Garcia AlvarezDepartment of Anesthesiology, Hospital de Sant Pau, University of Barcelona, Barcelona, Spain.
Ke PengDepartment of Anesthesiology, First Affiliated Hospital of Soochow University, Suzhou, China.
Maxime LégerDepartment of Anesthesiology and Intensive Care, Centre Hospitalier Universitaire d'Angers, Angers, France.
Wegdan KhalelDepartment of Anesthesiology, Tripoli Central Hospital, Tripoli, Libya.
Mukadder Orhan-SungurDepartment of Anesthesiology and Reanimation, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey.
Melanie MeerschDepartment of Anesthesiology, Intensive Care and Pain Medicine, University Hospital Münster, Albert-Schweitzer-Campus 1, Gebäude A1, 48149, Münster, Germany.
EPIS-AKI Investigators

Funding

Deutsche Forschungsgemeinschaft KFO342-1Deutsche Forschungsgemeinschaft ME5413/1-1Deutsche Forschungsgemeinschaft ZA428/18-1Deutsche Forschungsgemeinschaft ZA428/21-1
6 · The paper itself

Abstract

purposeThe incidence, patient features, risk factors and outcomes of surgery-associated postoperative acute kidney injury (PO-AKI) across different countries and health care systems is unclear.

methodsWe conducted an international prospective, observational, multi-center study in 30 countries in patients undergoing major surgery (> 2-h duration and postoperative intensive care unit (ICU) or high dependency unit admission). The primary endpoint was the occurrence of PO-AKI within 72 h of surgery defined by the Kidney Disease: Improving Global Outcomes (KDIGO) criteria. Secondary endpoints included PO-AKI severity and duration, use of renal replacement therapy (RRT), mortality, and ICU and hospital length of stay.

resultsWe studied 10,568 patients and 1945 (18.4%) developed PO-AKI (1236 (63.5%) KDIGO stage 1500 (25.7%) KDIGO stage 2209 (10.7%) KDIGO stage 3). In 33.8% PO-AKI was persistent, and 170/1945 (8.7%) of patients with PO-AKI received RRT in the ICU. Patients with PO-AKI had greater ICU (6.3% vs. 0.7%) and hospital (8.6% vs. 1.4%) mortality, and longer ICU (median 2 (Q1-Q3, 1-3) days vs. 3 (Q1-Q3, 1-6) days) and hospital length of stay (median 14 (Q1-Q3, 9-24) days vs. 10 (Q1-Q3, 7-17) days). Risk factors for PO-AKI included older age, comorbidities (hypertension, diabetes, chronic kidney disease), type, duration and urgency of surgery as well as intraoperative vasopressors, and aminoglycosides administration.

conclusionIn a comprehensive multinational study, approximately one in five patients develop PO-AKI after major surgery. Increasing severity of PO-AKI is associated with a progressive increase in adverse outcomes. Our findings indicate that PO-AKI represents a significant burden for health care worldwide.

Indexed as

Acute Kidney InjuryIntensive Care UnitsHumansProspective StudiesRenal Replacement TherapyRisk FactorsAcute kidney injuryEpidemiologyMortalityPerioperativePostoperative

Identifiers

PMID37505258
PMCPMC10709241

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Registered trials

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.