Observational studyCanadian journal of anaesthesia = Journal canadien d'anesthesie2025
Blood transfusion and acute kidney injury after cardiac surgery: a retrospective observational study.
Observational study in Canadian journal of anaesthesia = Journal canadien d'anesthesie, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed.
- The dose-effect relationship between red blood cell transfusion volume and adverse events in pediatric cardiac surgery.Translational pediatrics · 2026Article
- Development of a multivariable clinical prediction model for acute kidney injury after valve replacement surgery: incremental value of the triglyceride-glucose body mass index.Journal of thoracic disease · 2026Article
- Machine learning-based prediction of postoperative continuous renal replacement therapy initiation after open thoracoabdominal aortic repair.BMC nephrology · 2026Article
- Does preoperative homocysteine level influence the kidney functions after coronary artery bypass grafting?BMC cardiovascular disorders · 2026Article
- A Dynamic Approach to Assessing and Predicting AKI Risk in Patients with Aortoiliac Occlusive Disease Undergoing Aorto-Bifemoral Bypass.Diagnostics (Basel, Switzerland) · 2026Article
- Impact of occult renal dysfunction on postoperative acute kidney injury and late prognosis in elderly patients undergoing coronary artery bypass.BMC nephrology · 2026Observational
- Multicenter machine learning study for long-term prediction of acute kidney injury after complete mesocolic excision: integrating inflammatory biomarkers and transfusion-related risk factors.Frontiers in oncology · 2026Article
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7 authors.
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Abstract
purposeCardiac surgery-associated acute kidney injury (AKI) is linked to poor outcomes. An observational study from Copenhagen, Denmark identified perioperative red blood cell (RBC) transfusion as a modifiable risk factor for AKI, with a dose-dependent relationship between the number of RBC units transfused and the occurrence and severity of AKI. We aimed to externally validate those findings in a larger population.
methodsWe conducted a retrospective observational study of adult patients undergoing nonemergent on-pump cardiac surgery at Toronto General Hospital (Toronto, ON, Canada) between 2016 and 2021. Acute kidney injury was classified using the Kidney Disease: Improving Global Outcomes (KDIGO) criteria. Data were analyzed using inverse probability weighted logistic regression.
resultsAmong 5,204 patients, 798 developed AKI, with 77% classified as stage 1, 11% as stage 2, and 12% as stage 3. Patients with AKI were older, had lower preoperative hemoglobin levels and estimated glomerular filtration rates, longer cardiopulmonary bypass duration, and lower intraoperative hemoglobin levels. Red blood cells were administered to 37% of patients, with 14% receiving plasma and 32% platelets. Only RBC transfusion, alone or combined with other blood products, was significantly associated with AKI. The transfusion of 1-2 RBC units increased the probability of stage 1 AKI by 4% and stage 2-3 AKI by 2% compared with patients not receiving RBCs. The risk was especially pronounced with the transfusion of > 2 units of RBCs, which raised the probability of stage 1 AKI by 12% and stage 2-3 AKI by 9%.
conclusionsThis study confirms previous findings that RBC transfusion is associated with postoperative AKI in cardiac surgery patients. The association was strongest among patients who received > 2 units of RBCs. Prospective studies are needed to determine the optimal strategies for transfusion in these patients and evaluate potential alternatives.
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