Observational studyBMC surgery2025
Association between intraoperative lactate levels and acute kidney injury after on-pump cardiac surgery: a retrospective cohort study across two centers.
Observational study in BMC surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
What it found
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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.
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Who cites it
6 citing papers in PubMed.
- Lactate in acute kidney injury: pathobiology, risk stratification, and clinical interpretation.Renal failure · 2026Review
- Machine learning-based prediction of postoperative continuous renal replacement therapy initiation after open thoracoabdominal aortic repair.BMC nephrology · 2026Article
- Development and Validation of a Machine Learning Model for Predicting Serum Creatinine-Defined Acute Kidney Injury in Older Adults After Cardiac Surgery.Clinical interventions in aging · 2026Article
- Development and internal validation of a prediction model for hypoxic hepatitis after coronary artery bypass grafting with cardiopulmonary bypass.Frontiers in medicine · 2026Article
- Association between circulating biomarkers of endothelial glycocalyx degradation and postoperative acute kidney injury in patients undergoing cardiac surgery with cardiopulmonary bypass.Frontiers in surgery · 2026Article
- Postoperative lactate trajectories predict in-hospital adverse outcomes and differ by surgical approach in cardiac surgery: a propensity score-matched study.Frontiers in cardiovascular medicine · 2026Article
Corrections and comments
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Authors and funding
5 authors.
Funding
Abstract
backgroundHyperlactatemia and acute kidney injury (AKI) represent significant perioperative complications in cardiac surgery. This study investigated their relationship by analyzing multiple lactate parameters during on-pump cardiac procedures.
methodsIn this dual-center retrospective analysis of 5255 cardiac surgery patients, we evaluated the relationship between AKI and four distinct lactate parameters: baseline, mean, peak, and time-weighted average (TWA) concentrations. The association between lactate levels and outcomes was evaluated using restricted cubic spline functions with five knots in our retrospective statistical modeling approach. Concurrently, optimal lactate thresholds were determined through the application of a classification and regression tree algorithm.
resultsAmong the 5255 patients analyzed, 931 (17.72%) developed acute kidney injury. Statistical analysis revealed distinct patterns of association between lactate parameters and AKI risk. We identified an L-shaped relationship for mean, peak, and TWA lactate levels, contrasting with a linear association for baseline values. The study established critical thresholds for AKI risk prediction: mean lactate (2.96 mmol/L), peak lactate (4.50 mmol/L), and TWA lactate (2.33 mmol/L). Risk stratification demonstrated that patients in higher lactate quintiles faced substantially increased AKI risk, with odds ratios ranging from 1.34 to 4.37 across different lactate parameters.
conclusionThese findings established specific lactate thresholds as valuable predictive markers for AKI risk in cardiac surgery, offering clinically applicable parameters for perioperative risk assessment and management. This data supported the implementation of targeted lactate monitoring strategies during cardiac procedures.
trial registrationThe study was registered at www.chictr.org.cn (Registration number: ChiCTR2200057320, Data of Registration: 2022-03-08).
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